CYAdvance Mentor Volunteer Application
We are glad that you have decided to consider volunteering for Mentoring to Manhood (M2M). There are youth waiting to hear from you and want to have your guidance and support. Your consistent influence and involvement can change a young persons life, and can change yours. Thank you for taking a few moments to complete our application!
Email address *
Name *
Your answer
General Information
Email Address *
Your answer
Cell Phone *
Your answer
Home Address *
Street, City, State, Zip Code
Your answer
Date of Birth *
How long have you lived at this address? *
Marital Status *
Your answer
Educational and Professional Background
What is your highest level of education completed? *
Are you military/former military? *
Job Title *
Your answer
Company *
Your answer
Brief job description *
Your answer
Length of current employment? *
Your answer
Do you expect any change in your employment status during the next year? *
Can you be contacted at work? *
Your answer
Criminal History Check
Have you ever been charged with any criminal offense? *
If yes, what were you charged with? *
If no, please write N/A
Your answer
Please list three personal or professional references. *
Name and phone number
Your answer
How did you learn about our mentor programs? *
How do you want to volunteer? *
What time commitment can you make? *
Skills and Interests *
Select all that apply
Volunteer Agreement *
CERTIFICATION: I hereby certify that the information contained in this application is true, correct and complete. AUTHORIZATION TO RELEASE INFORMATION: I hereby authorize the references, employers, and educational institutions listed above, and any and all other individuals and entities contacted by CYAdvance for information about me, to release all information. RELEASE FROM LIABILITY: I release all parties and persons from any and all liability for any damages, which may result from furnishing such information to CYAdvance, as well as from the use or disclosure of such information by CYAdvance or any of its agents, co-workers or representatives. The undersigned acknowledges and agrees to the above stated information and that:
Digital Signature
By digitally selecting "Yes" below, you are acknowledging that all the information provided is accurate. If you have questions about the CYAdvance volunteer intake process, please call our office at 240-770-3870 or e-mail us at *
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