Mentor Application Form

Mentor Application Form
Name of Applicant*

First NameLast Name
Company
Occupation*
Home Phone
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Mobile Phone*
Please enter a valid phone number.Format: (000) 000-0000.
Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Gender*

MaleFemaleNon-BinaryOther
Language(s) Spoken*
Upload your resume (if available)*

Cancelof
How did you hear of BSOTC?*
Your Availability
Which days are you available for mentorship?*

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Please explain more about what days/times you are available to volunteer*
Mentorship Questions
Have you previously been a mentor for other organizations?*

YesNo
What are your areas of expertise? (check all that apply)*

Career PlanningProject ManagementLeadershipCommunity EngagementConflict ResolutionCollege PreparationCreative WritingFinanceComputer LiteracyYouth EmpowermentOther
Do you have previous volunteer experience? Provide a brief statement detailing what organization(s) and your role as a volunteer.*
Write a brief statement on why you have chosen to be a volunteer with Both Sides of the Conversation (BSOTC)?*
Please list the skill sets and strengths that you would bring to BSOTC.*
Is there any characteristics in a mentee that you may be uncomfortable handling? Please specify.*
Are you able to be a mentor for more than one person at the same time? *
Please specify if you prefer a one-on-one mentoring session or a group mentoring session
Which organizations are currently involved in or affiliated with?
Is there anything else you would like us to know?
By signing this, I certify that all statements on this Application are true and accurate. As condition of volunteering, I give permission for BSOTC to conduct a background check on me, which may include a review of sex offender registries, child abuse and criminal history records. I understand that, if appointed, my position is conditional upon BSOTC receiving no inappropriate information on my background. I also understand that, regardless of previous appointments, BSOTC is not obligated to appoint me to a volunteer position. If selected as a volunteer, I understand that, prior to the expiration of my tenure I am subject to suspension by the Executive Director and removal by the Board of Directors for violation of BSTOC policies or principles. I also understand that misinformation knowingly provided here, and on subsequent volunteer forms, is grounds for dismissal.
First and Last Name*
Signature*
Date*

MonthDayYear
Date
Should be Empty:

Mentor Application Form

Your Availability

Mentorship Questions