Communities In Schools of Chesterfield Mentor Application
Please complete this application to begin the process of being matched with a student! (Questions 2-8 are asked to match the data required for a background check.)
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Email *
Last Name *
First Name *
Middle Name
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Maiden Name
Date of Birth *
Race *
Phone Number
Home Address
Please list your weekday availability for an in-person office visit (Ex. Mondays 11am-1pm). During this half hour meeting, we will complete background check and volunteer agreement paperwork, and get to know you more.
A CIS-C staff member will be in touch to schedule your in-person visit. Please indicate how you would like to be contacted to schedule your visit.
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