Field Mentor Application

Name*

First NameLast Name

Email*

example@example.com

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Date*

Date

Address*

Street Address

Street Address Line 2

CityState

Zip Code

If you have a preferred name or pronouns, please list them here.

We may use SMS during the hiring process. Do you give us permission to text you at the number you provided? *

Do you have a valid drivers license?*

YesNo

Are you legally able to work in the United States?*

YesNo

Will you be at least 20 years old at the time of training?*

YesNo

Do you have a High School Diploma, GED or something equivalent?*

YesNo

Are you able to maintain visual and auditory awareness at all times for safety purposes?*

YesNo

Are you able to lift/carry 55+ pounds and hike 2-5 miles daily?*

YesNo

Given our client population, Mentors are required to submit to a criminal background check and drug screening prior to work, and random drug screenings during their time as a Mentor. (Of note, not all items that might appear on a background check would be disqualifying) Do you agree to those conditions?*

YesNo