Mentor Volunteer Signup
Thank you so much for wanting to volunteer with Y.A.M.M. We truly appreciate your desire to come alongside and help. You are a blessing!

This application packet contains the following:
• Application for mentoring
• Mentoring Description
Email address *
A Summary of Your Rights Under the Fair Credit Reporting Act
The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, fairness, and privacy of information in the files of consumer reporting agencies. There are many types of consumer reporting agencies, including credit bureaus and specialty agencies (such as agencies such as agencies that sell information about check writing histories, medical records, and rental history records). Here is a summary of your major rights under the FCRA. For more information, including information about additional rights, go to www.consumerfinance.gove/learnmore or write to: Consumer Financial Protection, 1700 G Street N.W., Washington, DC 20006.

• You must be told if information in your file has been used against you. Anyone who uses a credit report or another type of consumer report to deny your application for credit, insurance, or employment – or to take another adverse action against you – must tell you, and must give you the name, address, and phone number of the agency that provided the information.

• You have the right to know what is in your file. You may request and obtain all the information about you in the files of a consumer reporting agency (your “file disclosure”). You will be required to provide proper identification, which may include your Social Security number. In many cases, the disclosure will be free. You are entitled to a free file disclosure if:
• a person has taken adverse action against you because of information in your credit report;
• you are the victim of identity theft and place a fraud alert in your file;
• your file contains inaccurate information as a result of fraud;
• you are on public assistance;
• you are unemployed but expect to apply for employment within 60 days.

In addition, all consumers are entitled to one free disclosure every 12 months upon request from each nationwide credit bureau and from nationwide specialty consumer reporting agencies. See www.consumerfinance.gove/learnmore for additional information.

• You have the right to ask for a credit score.
• You have the right to dispute incomplete or inaccurate information.
• Consumer reporting agencies must correct or delete inaccurate, incomplete, or unverifiable information.
• Consumer reporting agencies may not report outdated negative information.
• Access to your file is limited.
• You must give your consent for reports to be provided to employers.
• you may limit “prescreened” offers of credit and insurance you get based on information in your credit report.
• You may seek damages for violators.
• Identity theft victims and active duty military personnel have additional rights.
Background Check Application and Consent to Request Consumer Report & Investigative Consumer Report Information
Sample of Background Check

I understand that Y.A.M.M. (“COMPANY”) will obtain a consumer report and/or investigate consumer report (“Report”) as part of the hiring process. I also understand that if hired, to the extent permitted by law, COMPANY may obtain further Reports so as to update, renew, or extend my employment.

I understand Y.A.M.M. investigation may include obtaining information regarding my credit background, bankruptcies, lawsuits, judgments, paid tax liens, unlawful detainer actions, failure to pay spousal or child support, accounts placed for collections, character, general reputation, personal characteristics and standard of living, driving record and criminal record, subject to any limitations imposed by applicable federal and state law. I understand such information may be obtained through direct or indirect contact with former employers, schools, financial institutions, landlords and public agencies or other persons who may have any means, including but not limited to personal interviews with my acquaintances and/or associates or with others whom I am acquainted.

The nature and scope of the investigation sought is indicated by the selected services below:
• Criminal Background Check
• SSN Trace
• Sex Offender Search

I acknowledge receipt of the attached summary of my rights under the Fair Credit Reporting Act and, as required by law, any related state summary of rights (collectively “Summaries of Rights”).

This consent will not affect my ability to question or dispute the accuracy of any information contained in a Report. I understand if COMPANY makes a conditional decision to disqualify me based all or in part on my Report, I will be provided with a copy of the Report and another copy of the Summaries of Rights, and if I disagree with the accuracy of the purported disqualifying information in the Report, I must notify COMPANY within five business days of my receipt of the Report that I am challenging the accuracy of such information with COMPANY.

I hereby consent to this investigation and authorize COMPANY to procure a Report on my background.

In order to verify my identity for the purpose of Report preparation, I am voluntarily releasing my date of birth, social security number and the other information and fully understand that all employment decisions are based on legitimate non-discriminatory reasons.

After you have completed the entire application, you will be contacted by a YAMM administrator. The administrator will get your consent to perform a background check.

Requested information will include
• A copy of your license
• Four references (2 non-family and 2 professional)
• Double check to make sure everything is signed and initialed
• Payment for background check.

PLEASE NOTE: There is a charge for background checks. You will be asked to bring in your payment or mail your payment. Applications will not be processed until payment is received. If mailing payment send to :

Attention: Kamm Galloway
YAMM Volunteer Coordinator
3661 Yale Ave.
Winston-Salem, NC 27101

Only cash and checks are accepted, please make checks payable to Y.A.M.M. with a memo note: Background Check.
Adult: $20 Student: $0 Intern: $0

Again, thank you for your desire to help.
Mentor Volunteer Description
Mentor Role
• Take the lead in supporting a young person through an ongoing, group and one-to-one relationship
• Serve as a positive role model and friend
• Build the relationship by planning and participating in activities together
• Strive for mutual respect
• Build the young person’s self-esteem and motivation
The mentor training provides the tools necessary to fulfill the mentor role as envisioned.
Application and Screening Process
• Written or typed application
• Criminal history check
• Sexual offender registry check
• Personal interview
• Provision of four personal references
• Attendance at one and half hour mentor training.

Participation Requirements
• Be at least 18 years old
• Be willing to adhere to all program policies and procedures
• Complete the application and screening process
• Be dependable and consistent in meeting time commitments
• Communicate bi-monthly with program staff and submit weekly report forms
• Accept constructive feedback regarding mentoring activities
• Have a clean criminal history (Felony convictions are acceptable)
• Not use illicit drugs, alcohol or controlled substances
• Not currently be in treatment for substance abuse
• If a previous substance abuser, must have had a non-addictive period of at least five years or Substance Abuse Counselor Certification
• Not have been hospitalized for mental disorder in the past three years.
• Be a friend, confidant

Desirable Qualities
• Interest in working with young people
• Willing listener
• Encouraging and supportive
• Patient and flexible
• Tolerant and open-minded of mentees views and ideas

Time Commitment
• Make a one-year commitment
• Spend one hour a week with a mentee
• Communicate with the mentee weekly
• Attend an initial one and half hour training session
• Attend mentor group events, mentor group supervision, and program recognition events.

Benefits to the Mentor
• Personal fulfillment through contribution to community and individual
• Satisfaction in helping someone mature, progress and achieve goals
• Training sessions and group activities
• Participation in a mentor support group
• Personal ongoing support and supervision to help the match succeed
• Mentee group activities and participant recognition events.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy