2022 Neighborhood Ninjas Mentor Application
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Full name *
What are your pronouns? ex. she/her/hers, he/him/his, they/them/theirs *
Birth Date *
Address (include city, state, zip) *
Best Phone Number (can we text you?) *
Email *
Employer *
Occupation *
Work Address (Address, City, State, ZIP)
Business Phone
Business E-mail
Prefered Mentoring Day(s) *
Prefered Mentoring Time *
Is there a gender you prefer to be matched with? *
Is there a specific age range you would prefer to work with between ages 6 and 22? Please note, you must be at least 5 years older than your mentee. *
Please let us know more about why you prefer to mentor someone this age. *
Would you be willing to work with a child who has disabilities? If so, please specify disabilities you would be able to work with. *
Do you speak any languages other than English? If so, which languages? *
Why do you wish to be a mentor in the program? What does mentoring mean to you? *
Describe special interests/hobbies, besides ninja, which may be helpful in matching you with a mentee (e.g., cooking, crafts, career interests, chess, stamp collecting, sports such as baseball or football, computers, art, needlepoint, speak another language, music, painting): *
How long have you been in the ninja community? *
Are you a coach at a ninja gym? If so, where? *
Are you a member at a ninja gym? Please tell us which gyms you most frequently attend. *
How far are you willing to travel to meet in person with your mentee? *
Are you willing to communicate regularly and spend at least one hour biweekly with your mentee? *
Are you comfortable meeting in person? *
Have you ever participated in a formal mentoring program as a mentee or mentor before? If so, tell us about your experience. *
Please tell us about any past informal mentoring experience you may have (i.e. coach, team captain, supervisor)? *
Describe the most influential mentor you’ve had in your life: *
Are you willing to undergo a background check to participate in the mentorship program? *
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