Be a mentor today
Join our team and work with a student, 1 on 1, and empower them to be the best version of themselves.
Name
*
First Name
Last Name
Gender
*
Male
Female
Transgender
Non-Binary
I decline to answer
Email
*
County
*
ex. Dekalb, Fulton, etc.
Cell phone number
*
-
Area Code
Phone Number
Birthday
*
-
Month
-
Day
Year
Date
Nationality
*
U.S. , Mexico, Colombia, etc.
School and Professional Information
I consider myself a:
*
College Student
Recent Graduate/Young Professional
University Faculty or Staff
Working Professional
Retired Professional
Other
What is the highest level of education you've received?
*
High School Degree Completed
Associate Degree Completed
Undergraduate Degree Completed
Graduate/Master Degree Completed
PhD Degree Completed
College or University you attended
In what did you major in?
Professional Job Title
*
Are you affiliated with an ERG or BRG? If so, please list name below. If not, please write N/A.
*
Please attach your most current resume and reference list.
Browse Files
Cancel
of
Why do you want to be a mentor?
Do you have previous volunteer experience, or experience working with youth? If so, please specify.
Please describe your strengths as a mentor for Latinx youth. How can your experience (personal, professional, or both) help guide or support a middle or high school student?
How would you describe your personality and interests? Select all that apply
*
Outgoing and Sociable
Sports Fan
Introverted or reserved
Lover of learning new things
Thrill seeker
Health Conscious
Foodie or Home Chef
Athletic
Nature Enthusiast
Pet Person
Artistic/Maker
Which similarities do you seek in a mentee? Select all that apply:
*
Characteristics/Personality type
Common interests
Family dynamics/Background
Career aspirations
Please indicate your mentee grade preference (check all that apply):
*
6th
7th
8th
9th
10th
11th
12th
Our mentees are students at the schools listed below. Please select the site(s) most favorable to you. While we will try to accommodate your preference when matching you, we cannot guarantee your request.
*
Sequoyah Middle School
Cross Keys High School
Lilburn Middle School
Meadowcreek High School
Tri-Cities High School
Chamblee Charter High School
Dalton Academy
McClure High school
No preference-- I'm open to all sites!
How did you hear about the Latino Youth Leadership Academy and its mentorship program?
Criminal History - By completing this application, you agree to immediately notify the Latin American Association should there be a change of circumstances that affects the accuracy of your answers in the following section, between the date you submit your application and your first day of mentorship.
Have you ever been convicted of or adjudicated to be guilty of a violent felony offense, required to register as a sex offender by any legal authority in the U.S. or any other country, or are any charges involving a violent felony or sex offense pending against you at this time?
*
No
Yes. If yes, complete the next question.
List all the offenses and/or pending charges, the date of each offense/charge, and the date of each conviction/adjudication. Also, describe the circumstances surrounding each offense/charge and if you wish, you may provide a statement as to why you believe this information should not be a cause for concern about the safety of the community.
*
Read Carefully
By checking the boxes below, I certify that the statements I have made in this application and include in subsequent correspondence are/will be complete and true to the best of my knowledge. I acknowledge that it is my responsibility to be aware of all pertinent application requirements and that I have read and understand all application instructions. I understand that failure to disclose complete and accurate information, or failure to submit all required application information and official documents including those outlined in the background check may result in the withdrawal or dismissal of mentor program or other corrective actions as necessary. Please note that applicants may be required to sign a driver affidavit and provide proof of current driver’s license and registration.
Personal Information
Completed
Personal Information
School/Professional Information
Resume & Reference List
Volunteer/Mentor Information
Criminal History
I hereby certify that the statements found above are true and complete
I acknowledge that this application does not guarantee a position as a mentor
I acknowledge and agree that I must attend mandatory training provided for mentors. Training dates will be sent to mentors via email closer to the date.
*
Yes, I acknowledge and agree to these terms.
I acknowledge that, if selected to become a mentor, I must complete an online background check form. This background check will be paid for by the Latin American Association after I submit my information.
*
Yes, I acknowledge and agree to these terms.
Submit
Should be Empty: