C.A.E. Champion Mentor Application

C.A.E. Champion Mentor Application

A Team Representative will contact you within 24 hours.
Name *

Prefix First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Date of Birth *

Month Day Year
Email *
example@example.com
Phone Number *

Area Code Phone Number
Social Media Handles
i.e. Facebook, LinkedIn and Instagram
Are you a convicted felon? *
Have you completed an FBI/BCI background check? *
Do you have reliable transportation? *
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
May we contact you if a need arises for your area of expertise? *
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? *
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. Clear
Should be Empty: