Mentor Volunteer Application

Welcome. Thank you for your interest in our mentoring program and for completing this application. All information collected on this application will be kept confidential within the mentoring program.

I am interested in applying for the following program:

Contact Information

First Name *This question is required.

Last Name *This question is required.

Date of Birth *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

Gender *This question is required.

Street Address *This question is required.

Apt/Suite

City *This question is required.

Zip *This question is required.

Please list all states you have lived in for the past 5 years. As part of our background check requirements for a federal grant, we are required to search child protection registries for each state you have lived in the past 5 years. *This question is required.

Primary Email Address *This question is required. This question requires a valid email address.

Secondary Email Address This question requires a valid email address.

Primary Phone Number *This question is required. Please provide a 10-digit phone number including area code.
Enter numbers only. Formatting such as dashes will be added as you enter your phone number.

Secondary Phone Number

If you said other, please specify.

Employment Information, if applicable

Employer

Occupation

Work Street Address

Apt/Suite/Office

City

Zip

May we contact you at work?

Work Phone Number *This question is required.

What church, if any, do you attend? If you don't attend, put "N/A." *This question is required.

How did you learn about our program? *This question is required.

Briefly describe your motivation for applying to become a mentor with JIFF. *This question is required.

What are your strengths and weaknesses? *This question is required.

What personality do you think you work best with? *This question is required.

What, if any, other groups or organizations have you been involved with as a volunteer? *This question is required.

Do you have experience working with children? *This question is required.

If so, please explain and how this experience will help you be an effective JIFF mentor? *This question is required.

Mentoring a young person is a big responsibility and can change the lives of both you and the mentee. What do you hope to gain from the experience and what do you hope the mentee gains? *This question is required.

What languages are you comfortable speaking? *This question is required.

Arabic
Chinese (Mandarin, Cantonese)
English

French
Korean
Somali

Spanish
Swahili
Tagalog

Vietnamese
Other

If you said other, please specify.

Your Interests *This question is required.

If you said other, please specify.

What types of activities would you do with a mentee? *This question is required.

How would you describe yourself? *This question is required.

What are some of the biggest challenges in the community that concern you? *This question is required.

What are the most convenient days and times for you to meet with your mentee? *This question is required.

Monday AM
Monday PM

Tuesday AM
Tuesday PM

Wednesday AM
Wednesday PM

Thursday AM
Thursday PM

Friday AM
Friday PM

Saturday AM
Saturday PM

Sunday AM
Sunday PM

Other

Availability Comments:

Who else in your household might be present at any given time when you are with your mentee? *This question is required.

Are you willing to communicate regularly and openly with program staff and provide monthly information regarding your mentoring activities? *This question is required.

Are you willing to complete a mentor orientation session and trainings as may be scheduled before and after being matched? *This question is required.