Mentor Application 2017-18
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. Please complete this application by Friday, August 25, 2017.

For questions, please email thecardinalnest@gmail.com or call 216-816-1263.

Full Name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Street Address
Including City, State, & Zip
Your answer
Home Phone
Your answer
Cell Phone
Your answer
Email Address
Your answer
Professional Title
Your answer
Select the highest level of education that you've attained.
High School
Your answer
College(s)/Post-Secondary Institution(s)
Your answer
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?
Your answer
What experiences have you had as a mentor/positive role-model to youth?
Your answer
Professional Field Experience
Check all that apply.
Required
What grade level would you like to work with?
How did you hear about this program?
Your answer
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.
Your answer
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