Mentor Application
Last Name *
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First Name *
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Middle Name
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Address *
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City *
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State *
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Zip Code *
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Home Phone
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Cell Phone *
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Work Phone
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Which number is best to reach you?
Birthdate *
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Tell Us About You
Marital Status *
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Spouse/Partner's Name
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Children
Names and Ages
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Household Income
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Occupation *
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Highest Level of Education *
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Hobbies *
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How Do you Define Success? *
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Mentoring Experience
Have you been a mentor in the past? If so, with who? *
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Are you currently involved with any other mentoring organizations or associations? *
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Why are you interested in becoming a mentor with ToGetHer Empowered, Inc.? *
Your answer
What mentoring program are you applying for? *
Required
Recruitment Purposes
This information helps us know where our mentors are coming from within the community so that we can match them with a mentee in their area.
In which city do you reside? *
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In which city do you work? *
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Program Overview
The ToGetHer Empowered Mentoring Program is designed with the purpose of uniting women and girls of color together to form a bond of sisterhood. Mentors will undergo a extensive interview process prior to being matched with either a youth or adult mentee. As part of the interview process, potential mentors are required to obtain a criminal background check from their local police department. Upon completion of the interview, mentors will be notified of their acceptance into the mentoring program and will be required to complete the mentoring training program. All mentors must be a member of ToGetHer Empowered in good standing. All activities and financial commitments are required to be met before becoming an active mentor and being assigned a mentee.
Meeting Attendence
1. Attend financial management course.
2. Attend etiquette training course.
3. Connect with mentee weekly
4. Attend all required continuing education mentoring courses.
Financial Requirement (Youth Mentors Only)
1. Cost of etiquette and financial management courses
2. Cost of criminal background check
3. Mentors are responsible for sponsoring their mentee at for all events and activities not covered by ToGetHer
Empowered, and
4. Any subsequent cost of mentoring.
Volunteer Placement
1. Participate in the New Member Community Project
2. Work a 4 hour fundraising shift
Eligibility Requirements
1. Must be a ToGetHer Empowered member in good standing.
2. Must be at least twenty‐two (22) years of age. No maximum age restriction.
3. Must be financially equipped to maintain the financial responsibilities of mentoring
4. Must be able to commit 1 day a week to meet/connect with mentee
5. Completed and signed application
I fully understand the requirements and agree to complete the Mentoring Program responsibilities.
Applicant Signiture *
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Today's Date *
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