C.A.E. Champion Mentor Application
A Team Representative will contact you within 24 hours.
Name
*
Mr.
Mrs.
Ms.
Rev.
Min.
Dr.
Prefix
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of Birth
*
-
Month
-
Day
Year
Date Picker Icon
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Social Media Handles
i.e. Facebook, LinkedIn and Instagram
Are you a convicted felon?
*
Yes
No
Have you completed an FBI/BCI background check?
*
Yes
No
Do you have reliable transportation?
*
Yes
No
SKILLS AND QUALIFICATIONS
Please check all area(s) of expertise that applies:
Administrative: Grant-writing/Fundraising/Social Media/Blog/Writing
Business: Entrepreneurship/Marketing/Workforce Development
Community: Networking/Service
Culinary Arts: Baking/Cooking/Catering/Food Truck
Development: Social & Emotional (Youth/Adult)/Leadership Development
Education: Financial/Academic Tutoring/ACT/SAT/GED/STEM
Events: Planning/Decorating/Ticket Sales
Health & Fitness: Nutrition/Strength & Conditioning/Recreation/Sports
Multimedia: Photography/Video/Web Design/Graphic Design/Film
Performing Arts: Music/Theatre/Dance/Spoken Word
Technology: Coding/Robotics
Trade: Electrical/Mechanic/Auto Body/Construction/Sewing
Other
May we contact you if a need arises for your area of expertise?
*
Yes
No
MENTORING OPPORTUNITIES
Which C.A.E. branded workshop do you have the most interest in helping with?
C.A.E.'s "S.T.O.M.P." (Students Taking Ownership Mentoring Project) (Character & Leadership Development)
C.A.E.'s SWAGG Station (Dance & Media)
C.A.E.'s Makin' the Band (Music & Media)
C.A.E./Camp Tech 360 Experience (Technology)
C.A.E.'s The LEGITIMATE Hustle (Business & Culinary Arts)
C.A.E.'s Drone-preneur (Business & Technology)
C.A.E.'s Arts-N-Motion (Health & Fitness, Media and Dance)
C.A.E.'s Young Enterprise Money Maker$ (Entrepreneurship)
C.A.E.'s Positive Disruption (Social & Emotional Development)
C.A.E. TV Productions (Media & Film)
Not sure at this present time
How many hours per week are you available?
*
One Hour Per Week
Two Hours Per Week
Three Hours Per Week
Four or More Hours Per Week
What specific days and times are you available to instruct/mentor participants?
*
i.e. Monday - 4pm to 6pm
How comfortable do you feel speaking in front of a group of people?
*
Extremely Comfortable
Comfortable
Somewhat Comfortable
Not Comfortable
VOLUNTEER WORK
Please list your previous volunteer work
Please list your current community activities
clubs, religious, fraternal and civic organizations
How did you learn about C.A.E?
*
Facebook
Instagram
Google
Website
Friend
Employee
CAE Partner
REFERENCES
Please list three references over the age of 21 and not a family member.
*
Name
Address/Zip code
Phone
Relationship
Reference
Reference
Reference
I certify that the information in this application is true and correct to the best of my knowledge. I give consent that my references may respond to a verbal or written request for further information from C.A.E. I am willing to undergo a background check. I understand that I must complete a training period before working with C.A.E. I agree to sign a Confidentiality Agreement. I understand that my application and all information contained herein will be held in strict confidence by C.A.E. and will not be released to any outside party without applicant’s consent.
*
The electronic signature, whether digital or encrypted, is intended to authenticate this document and to have the same force and effect as a manual signature.
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