CIP Mentor Application
This form allows a CIP Mentor to edit their existing prior application or to apply if they are a new Mentor. Please correct or input the data for each question below.

For more information on CIP including a list of important dates, please see the website on
Email address *
12th Grade Career Internship Program Mentor Application

* Mentors MUST submit their "CIP Mentor Application and Proposal" electronically via this Google Form, on or before FRIDAY, MAY 1st, 2020.

* Upon submission, an email will be sent to you with your "CIP Mentor Application and Proposal" which will contain more information about the CIP program and your Mentor obligations.

** Please note: Some or all information submitted here will be provided to any matched CIP Student Intern and their parents/caregiver. **
In compliance with the NJ Department of Labor Child Labor Laws, the school district and business/agency will ensure that the student and parent or guardian understand that the student is not entitled to wages or an offer of employment at the conclusion of the unpaid Career Internship.

District Name: Montclair
District/School Code: 3310/810320
Mailing Address: 100 Chestnut Street, Montclair, NJ 07042
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