Mentor Application: NCNW-SI and PRHS                                        Youth Leadership Public Speaking Program
Thank you for volunteering to be a mentor for a student enrolled in the Youth Council or Port Richmond High School-NCNW-SI Youth Leadership Program. The questions below will gather some biographical information and your expertise and interests to help us create the most mutually beneficial mentorship.
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All mentors who work face-to-face with students will be required to show proof of vaccination against COVID-19. *
Please select which program you would like to work with. You may select both.
Which role(s) are you interested in fulfilling?
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Last Name, First Name *
Email *
Phone Number *
Social Media handles
How can students or staff best reach you? Please check the following in priority order.
Do not use this for regular contact
Phone (text)
Phone (voice)
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Describe your availability. For example, when should staff or students not contact you? What is the degree of your availability, once a week, once a month, etc.? *
Academic degrees and professional titles *
Current and past occupations *
Primary tasks associated with your occupation(s)
The future of your current profession. How do you see your profession changing over the course of the next 5-10 years?
Please describe any previous mentorship experience.
How do you envision your role and the outcome of the mentorship?
What talents or skills do you have outside of your profession that you can share with your mentee?
Please describe any public speaking training or experiences that you have had.
Reference(s). Please list name, relationship and contact information of at least one reference. *
Please provide any organizational affiliations you would like to share.
Where did you hear about this mentorship opportunity?
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