Mentor Application 2018-19
Thank you for your interest in being a role model for high school students in East Cleveland and surrounding neighborhoods. Please complete the following application to let us know you better and match you with an appropriate student.

For questions, please email thecardinalnest@gmail.com or call 216-816-1263.
Full Name *
Date of Birth *
MM
/
DD
/
YYYY
Street Address *
Including City, State, & Zip
Home Phone *
Cell Phone *
Email Address *
Professional Title *
Select the highest level of education that you've attained. *
High School *
College(s)/Post-Secondary Institution(s) *
How would you describe your personality? *
Check all that apply.
Required
What do you do in your free time? *
Check all that apply.
Required
What do you hope to accomplish as a Cardinal Nest Mentor? *
What experiences have you had as a mentor/positive role-model to youth? *
Professional Field Experience *
Check all that apply.
Required
What grade level would you like to work with? *
How did you hear about this program? *
As a mentor of The Cardinal Nest Inc., I agree to serve as a mentor for a minimum of one academic year. I will meet with my mentee(s) at lease once per month and attend outings as scheduled. I will serve as a positive role model and confidant for my mentee(s). In the case that I am no longer able to serve as a mentor, I will contact a Cardinal Nest staff member in a timely manner. *
Electronic Signature *
Please type your full name.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy