Amplified Mentoring Program Volunteer Mentor Application
The Volunteers of America, Utah Amplified Mentoring Program connects youth ages 12-17 with a one-to-one volunteer mentor in the Wasatch Front community. Mentors and mentees meet for 6 to 8 hours per month for a minimum of 9 months.
For the safety and security of of youth in our program, all volunteer applicants will need to have a background check completed and cleared through the Utah State Office of Licensing before being matched with a youth.
Email address *
First Name *
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Middle Name
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Last Name *
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Date of Birth *
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Relationship Status *
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Gender *
Race/Ethnicity (check all that apply) *
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Home Address
Street Address *
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City *
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State *
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ZIP *
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Primary Phone Number *
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Work Phone Number
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Emergency Contact
Emergency Contact Name *
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Phone Number *
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Relationship *
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