Mentor Application
Please complete all sections listed below
First Name *
Your answer
Last Name *
Your answer
Gender *
Mailing Address *
Your answer
Phone Number *
Your answer
E-mail Address *
Your answer
If you are an HISD Employee, please type e-mail address
Your answer
Contact Preference *
Employer *
Your answer
Job Title *
Your answer
Highest Level of Education Attainment *
Preference of day (select all that apply) *
Required
Choice of Schools ( Please choose your first option from the list below) *
Choice of Schools ( Please choose your second option from the list below) *
Mentor Pledge
I understand the need to maintain confidentiality regarding information that I might gain about students, families, and staff as I volunteer in the schools. I also understand that I am not to discuss individual student progress or behavior with anyone other than school personnel. I understand that if I violate school confidentiality rules, I may be asked to terminate my volunteer service. *
Required
If I am selected to be a mentor I understand that my commitment involves spending a regularly scheduled time weekly at the assigned school with my mentee throughout one school year. As part of my participation in this program, I will communicate with the ROSES Program Manager on a regular basis. * *
Required
Pursuant to Section 22.0835 of the Texas Education Code, I understand Houston ISD is required to conduct a criminal history review and reserves the right to receive and review any records maintained by any law enforcement agency.
I hereby declare that all statements in this profile application are true and accurate. *
Required
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