TVP 2022-2023 Mentor Application
Mentor Application & Matching Form
Name
First Name
Last Name
Phonetic Spelling of Name
Preferred Pronouns
(e.g. she/her/hers, he/him/his, they/them/their, etc.)
Date of birth
-
Month
-
Day
Year
Date
Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cell Phone Number
-
Area Code
Phone Number
Opt into text messages (TVP will send at most 2-3 text messages per month with resources and reminders for upcoming events)
Yes
No
Email
example@example.com
How was the Valedictorian Project brought to your attention?
Each Mentee is partnered with two mentors, which category are you interested in? [Review Mentor Information Sheet for reference]
Peer Mentor
Senior Mentor
Unsure
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Demographics
*Please note that individual demographic information is kept confidential, and only shared rolled-up anonymously into group data.*
In your own words, what is your gender identity?
Select the term(s) with which you most identify, even if the same as above
Cisgender (non-trans) Man
Cisgender (non-trans) Woman
Agender
Gender Non-Conforming
Intersex
Transgender Man
Gender Variant
Non-binary
Transgender Woman
Two-Spirit
Gender Queer
Prefer not to say
Are you of Hispanic, Latino/a/x, or Spanish origin?
Yes
No
Prefer not to say
In your own words, what is your race? (Please leave blank if prefer not to answer)
In your own words, what is your ethnicity? (Please leave blank if prefer not to answer)
Select the term(s) with which you most identify, even if the same as above
Black or African American
Indigenous Peoples, American Indian or Alaskan Native
Asian
Native Hawaiian or Pacific Islander
White
What languages do you speak conversationally? (Check all that apply)
Arabic
Canotonese
Cape Verdean Creole / Portuguese
English
Haitian Creole / French
Italian
Mandarin
Russian
Spanish
Vietnamese
First-Generation Status (Select all that apply)
I identify as First-Generation American
I identify as First-Generation College Student
I identify as an immigrant
Prefer not to say
None of the above
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Education
What is the highest degree or level of school you have completed?
Less than a high school degree
High school degree or equivalent (e.g. GED)
Some college, no degree
Associate's degree (e.g. AA, AS)
Bachelor's degree (e.g. BA, BS)
Master's degree (e.g. MA, MS, MEd)
Doctoral or professional degree (e.g. MD, DDS, PhD, JD)
What school(s) have you attended?
Are you a graduate of Boston Public, Lawrence, or Worcester Public Schools?
Yes - Boston
Yes - Lawrence
Yes - Worcester
No
Majors/Minors
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Employment & Career
What is your current employment status? (Check all that apply)
Employed full-time (40 or more hours per week)
Employed part-time (up to 39 hours per week)
Unemployed and currently looking for work
Unemployed and not currently looking for work
Student full-time
Student part-time
Retired
Homemaker / caregiver
Self-Employed
Prefer not to say
What is your current/recent employer (if applicable)
What industries do you have experience in?
Agriculture
Architecture
Banking
Biotechnology
Business
Civil Engineering
Construction
Consulting
Education
Energy
Engineering
Fashion & Apparel
Environmental
Finance
Food & Beverage
Government / Public Affairs / Policy
Healthcare
Hospitality
Individual/Household
Insurance
Law & Litigation
Manufacturing
Marketing & Advertising
Media & Communciations
Nonprofit
Logistics & Operations
Pharmaceuticals
Real Estate
Recreation
Religious
Technology & Electronics
Sports & Entertainment
Telecommunications & Utilities
Transportation
Visual/Performing Arts
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Personal
Tell us about yourself
Your Hobbies and Interests
Electronic Games
Film
Music
Volunteering
Performing Arts
Politics
Reading / Literature
Sports
Travel
Visual Arts
Cooking/Baking
What Best Describes you (select up to three)
Outgoing
Business-oriented
Constructive
Empathetic
Funny
Intuitive
Passionate
Reserved
Reflective
Vibrant
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Mentor Experience
What is your previous mentorship experience? (Select all that apply)
Experience in youth mentorship (K-12)
Experience in college student mentorship
Experience in professional mentorship
None
The role you would like to play as a Mentor (select up to three)
Colleague
Nurturer
Listener
Teacher
Motivator
Career Development
Life Coach
How comfortable do you feel helping your mentee navigate the following:
Very Uncomfortable
Somewhat Uncomfortable
Neither Comfortable nor Uncomfortable
Somewhat Comfortable
Very Comfortable
Financial Aid
Academics
Campus Social Life
Budget/Finances
Time & Task Management
Stress Management
Career Exploration
Job Search
Interview Prep
What do you hope to gain from your mentoring experience with TVP?
Describe a mentor you had throughout your career. What support did they provide you? What is one value of theirs that you would like to emulate as a mentor?
Mentors often have a particular set of experiences to share, please help us achieve the best possible match by specifying if you would like to mentor a student from a specific cultural or identity background (if available)?
Please note that while your answers help us to make the best possible mentor-mentee match, they do not impact your eligibility for the program. TVP does not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin, disability, marital status, sexual orientation, or military status in any of its activities or operations.
What questions do you have for Team TVP?
How did you hear about us?
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Please provide a personal or professional reference
First Name
Last Name
Email
example@example.com
Upload Resume/CV
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