Please enable JavaScript in your browser to complete this form.Mentor application formDate Personal informationName *FirstLastAddress *Address Line 1CityFloridaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip Code Date of birth *Email *Phone *Shirt size *Choose oneChoose oneRemove itemChoose oneChoose oneSmallMedium LargeXL2XL3XLOccupation *Mentor ProfileMotivation and Commitment *What inspired you to become a mentor? How do you plan to balance your mentoring responsibilities with your other commitments?Experience and Qualifications *Can you share your previous experiences working with youth or in mentorship roles? What skills or expertise do you bring that would benefit the participants?Approach to Mentorship *How do you build trust and rapport with young individuals? What strategies do you use to address challenges or conflicts that may arise during the mentoring relationship?Understanding of Youth Empowerment *What does youth empowerment mean to you, and how do you stay informed about the issues and challenges facing today's youth?Program Alignment *How do you see your role contributing to the goals of this specific program? What are your expectations from the program organizers to support your mentoring efforts? Mentor AssessmentHave you had any convictions in the last 10 years for crimes against persons or families, public indecency, or controlled substance violations? *YesNoIf the answer is YES, please explain below:Educational background. (check all that apply): *Some high schoolHigh school graduateSome collegeCollege graduateGraduate/professional schoolTechnical schoolOtherOtherPlease indicate the days of the week you are available to mentor. We are seeking mentors who can offer regular availability to effectively support our youth participants. (Check all that apply): *MondayTuesdayWednesdayThursdayFridaySaturdaySundayPlease indicate the most convenient times for you to mentor. (Check all that apply): *MorningsAfternoonsEveningsWeekendsWeekdaysPersonal referencesPlease list two references (you may include family members, personal friend and/or work reference):Reference One *FirstLastPhone *Reference Two *FirstLastPhone *DISCLAIMER AND ACKNOWLEDGEMENTBy completing this application to become a mentor, I acknowledge that the Give A Day Foundation (GADF) conducts routine background checks for all volunteer mentors. By signing below, I grant GADF permission to perform this background check. I affirm that, to the best of my knowledge, all information provided in this application is accurate and truthful.Signature *Clear SignatureSubmit
