JUMP Mentor Application
Dear Potential Mentor,

Thank you for your interest in JUMP, the Johnston Schools Youth Mentoring Program.  JUMP is a one to one program that facilitates one hour mentoring sessions that occur during school hours.   Our mission is to build positive relationships to help young people reach their full potential.  

Mentors serve as positive role models sharing in a variety of activities from helping students set and achieve goals to reinforcing basic lessons in life.  Students benefit from the program by receiving support and guidance from a caring adult, experiencing greater self-worth and motivation to succeed, and improving interpersonal relationships with peers, teachers and family.   Mentors also benefit by increasing their involvement in the community, recognizing they can make a difference, gaining new experience and knowledge about youth and the school system and by making a new friend.  

To ensure the safety of our students and help our mentors have the best experience possible, the process to become a JUMP mentor includes an interview, a criminal background check, Department of Human Services child and dependent adult abuse checks and mentor training.  

If you are interested in becoming a mentor, please complete the following forms.  Included are requests for contacting references from different areas of your life.  Please give us a name and contact information for each of the following three reference types:  a family member, employer and friend.  If you have any questions about the application process, please don't hesitate to contact Karen Henderson (JUMP Recruitment Coordinator) at karen@johnstonpartnership.org or 515-991-3399.

To learn more visit: https://johnstonpartnership.org/jump/

Thank you for your interest in making a difference in the life of a Johnston student! 


Chris Wilson
JCSD Director of SEMBH

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Email *
Mentor Application
Name *
Date of Birth *
Marital Status *
Address, City, State and Zip Code *
Primary Phone Number *
Employer/Occupation *
Ethnic Background (choose all that apply) *
Highest level of education completed *
Please give a brief statement as to why you would like to be a JUMP Mentor *
How did you learn of JUMP or how were you recruited? *
Do you have any previous mentoring experience? *
If Yes, please provide additional information about that experience.
Do you speak a foreign language? *
If Yes, what language(s)?
Emergency Contact Name & Phone Number *
Are there any medical conditions the school district should be aware of?
Johnston Community School District has my permission to complete a criminal background check, as well as a child/adult abuse registry screening.  I understand periodic background checks and child/adult abuse inquiries may be completed at any time. *
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