Life Long Mentors Volunteer Application Form

Life Long Mentors is a Not-For-Profit Organization founded in 2020 dedicated to shine the light on mental health recovery through the lens of a peer support guided model. We offer individualized peer support mentoring specialized for adolescents between the ages of 18-24 experiencing mental health challenges. Our goal is to encompass all elements of peer support including peer listening, education, and mentoring in your mental health recovery process.

We encourage the participation of volunteers as prospective peer supporters who support our mission and are willing to contribute. The information provided through this form will be kept confidential and will help us determine and select the most appropriate volunteers to join our program

Should you have any questions or concerns prior to filling out this form, please reach us via email at lifelongmentors@gmail.com

Name

PrefixFirst NameLast Name

Birth Date

MonthDayYear

Your age

Email

example@example.com

Phone Number

Area CodePhone Number

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Educational Background

Occupation/ Most Applicable Job Experience

Do you have prior experience working or volunteering as a Peer Support Worker?

Please select the categories in which you have worked and/or volunteered in

Please list below all relevant volunteering experiences (You may choose to copy and paste from your resume)

Do you have lived experience with mental health challenges and or recovered from a mental health illness?

YesNo

Required Qualifications Please check all that you have completed to date. If there is something that you have not completed, we will get in touch with next steps. *Note: Volunteers are able to submit an application even if one or more of these required qualifications are not yet completed

Completion of grade 12 or equivalentSuccessful completion of Mental Health First Aid (MHFA) certificationA record free Police Information check with vulnerable sector check (can be completed if selected for volunteer training)ASIST Suicide Intervention Program CertificateClass 5 Driver's license

Additional Preferred Qualifications (please check all that apply):

Formal education (completion of degree, certificate, diploma) in a psychology-related field, social work, or mental health related disciplinePrevious work or volunteer experience in mental health, crisis intervention, trauma-informed practice, harm reduction, or addictionsQPR Suicide Intervention Training certificateType option 4

Lifelong Mentors prides itself in selecting volunteers who demonstrate the following key characteristics: a non-judgmental attitude, heightened level of maturity, professionalism, a willingness to learn, and excellent communication and listening skills. Please take this space to list each key skill and describe a time when you demonstrated each characteristic

Please list contact information (Name, Email, and Phone Number) for 3 professional references. Please separate each reference contact information by using the space bar

Please upload a copy of your current Resume

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How comfortable are you with sharing your own personal experience as it relates to mental wellbeing with your mentee?

Very ComfortableSomewhat comfortableNot Comfortable at all

If accepted, the next part of the application process is an individual interview conducted virtually. Are you comfortable with attending an interview, if selected?

YesNo

All accepted peer support mentors will be expected to complete a 20-hour mandatory training program offered by Lifelong Mentors before beginning volunteer work. Is this something you can commit to ? More information will be provided at a later stage

YesNo

Describe your ideal mentee whom you would wish to be paired up with as a Peer Support Mentor

Select your available days for volunteering

From

:HourMinutesAM/PM Option

To

:HourMinutesAM/PM Option

Date

Signature