Mentor Application

  • Date Format: MM slash DD slash YYYY
  • HOME INFORMATION

  • EMERGENCY CONTACT

  • EMPLOYMENT INFORMATION

  • PERSONAL INFORMATION

  • EDUCATION

  • MENTORING COMMITMENTS AND LIFESTYLE

  • • Commit to one year mentoring a young person in the program
    • Visit mentee twice/month during the first three months and once/month thereafter
    • Contact mentee once/week by phone, email, text, Facebook, etc.
    • Check in with mentee’s Program Coordinator approximately once/month
    • Attend a New Mentor Training
    • Respect the wishes and guidelines of mentee’s parents/guardians
    • Respect confidentiality of mentee and family, barring situations such as child abuse.
  • Employment, residence or personal life (i.e. marriage, divorce)
  • The information I have provided in this application is, to the best of my knowledge, true and complete. I grant permission for the “I Have a Dream” Foundation-Los Angles to verify this information, contact my references, and run a background check that will include contacting the DMV and the Department of Justice. I agree to provide a copy of my driver’s license and auto insurance policy, pay the small background fee, and to participate in a home interview. I understand and agree to the mentoring commitments outlined herein.
  • Date Format: MM slash DD slash YYYY
  • REFERENCE I (SUPERVISOR/EMPLOYER)

  • REFERENCE II (PERSONAL)

  • REFERENCE III (PERSONAL REFERENCE)

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