Returning Mentor Application
Which campus or campuses are you applying to mentor at?
*
Avalon High School
Ellis County Juvenile Justice Alternative Education Program - Waxahachie
Ennis High School
Ferris High School
Grandview High School
Heritage High School
High Point Academy (Fort Worth)
Hillsboro High School
Italy High School
Keene High School
Life High School Oak Cliff
Maypearl High School
Midlothian High School
Milford High School
Palmer High School
Red Oak High School
Waxahachie High School
Wylie High School (Abilene)
If you selected multiple schools, please tell us the order of preference if any, or would you be willing to serve at all of the selected campuses?
Applying for school year
year
*
/
year
*
.
Example: 2023/2024.
Name
*
First Name
Middle Name
Last Name
Alias(es), if any:
Gender
*
Male
Female
Residential Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone
Please enter a valid phone number.
Cell Phone
*
Please enter a valid phone number.
Name/Address of Employer
Company Name
Street Address
City
State / Province
Postal / Zip Code
Does your employer have a charitable giving program (corporate donations, grants, volunteer hour match funds, etc.)
Yes
No
Unsure
Work Phone
Please enter a valid phone number.
Occupation
*
Email Address
*
example@example.com
What days of the week are you available to volunteer? (check all that apply):
*
Monday
Tuesday
Wednesday
Thursday
Friday
What is the best time for you to volunteer? (check all that apply):
*
Morning
Afternoon
Please list the years in which you served as a mentor for Mentors Care and the names of the students you’ve mentored.
*
If any particular student that you’ve previously mentored is returning to the Mentors Care Program for the school year, would you be interested in mentoring this student again?
*
Yes
No
If “yes”, what is the student’s name?
Please read and then place your initials beside each of the statements set forth below, evidencing that you’ve read, understand, acknowledge and agree with each statement.
I understand that the mentor program will require that I spend a minimum of one hour with my assigned mentee each week for the academic school year.
*
I understand that I will be required to complete the application process and a mentor program training & orientation before I will be assigned a mentee or otherwise allowed to meet with any students served by the organization.
*
I understand that I must contact a Mentors Care coordinator if I cannot attend a session with my mentee for any reason, as soon as I realize that I won’t be able to do so.
*
I understand although Mentors Care neither prohibits nor condones off-campus visits and meetings between mentors and mentees, inappropriate relationships of any kind between mentors and mentees are absolutely prohibited. Mentors Care will have no duty or liability whatsoever to any mentor who chooses to participate in any such off-campus meetings, in connection with any claims, causes of action, demands, lawsuits, harm or loss of any kind arising from, out of, or in connection with any such off-campus meetings. Mentors are role models for the students they mentor, and should always act in a manner that is reflective of that fact and respectful of the students we serve.
*
By my signature below, I represent and warrant that the information I’ve provided in this application is true and correct in all material respects and that I have not omitted or otherwise failed to disclose any information which might be of material relevance to Mentors Care or to its consideration of this application.
*
Date
*
-
Month
-
Day
Year
Date
If your application doesn't submit, please click the save button, copy the shareable link that it gives you on the next page and email it to sean.byars@mentors.care or text it to 469-658-1709
Save
Submit
Should be Empty: