Guest GEM Mentor Application Form

GUEST GEM MENTOR APPLICATION

What a feeling it is to give back!

Pour your expertise into the youth and young adults in your community as a Guest GEM Mentor.

Job Title: Guest GEM Mentor

Purpose: The Guest GEM Mentor is a volunteer role within GEM CULTURE, a non-profit youth organization serving divergent thinkers and creatively gifted teenage girls, ages 13-18, who identify as Black, Indigenous, or Persons of Color (BIPOC). The Guest GEM Mentor will serve in the capacity as a guest role model and mentor for the organization's participants, providing insight in their respective fields via panel discussions, guest hosting, field experiences, etc. that will support GEM CULTURE’s mission and our GEM Mentors in their guidance, support, and encouragement to our GEMS to help them reach their full potential.

Duties and Responsibilities:

Serve as a mentor and role model to the organization's participants for invited events and occasions
Engage with the participants in activities, discussions, and events
Provide guidance and support to the participants on their personal and academic journey
Attend Guest GEM Mentor Orientation at the start of the semester in which they have been invited to be a Guest GEM Mentor in order to be informed and up-to-date on the organization's programs and initiatives and their role in it
Be a positive representation of GEM CULTURE and its values
Qualifications:

Qualifications:

Passion for working with and supporting young girls who identify as BIPOC
Excellent communication and interpersonal skills
Ability to work as part of a team and collaborate with others
Ability to maintain confidentiality and respect the privacy of the organization and its participants
Ability to commit to serving as a Guest GEM Mentor for at least one session or event

If you are unable to commit to the time requirements of a GEM Mentor but would still like to serve as a role model, this is the perfect fit for you! You don’t need to have a child of your own to get involved—you just need to be passionate about helping others. Your local GEM Village Council can help get you started.

Name of Applicant*

First NameMiddle Initial

Last NameMaiden/Former Last Name (write "N/A", if not applicable)

Title/Position*

Preferred Name

Phone Number*

Please enter a valid phone number.

Email*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Civil Status*

SingleMarriedDivorcedWidowed

Gender*

Date of Birth*

Date

Social Security #*

Name as it appears on Social Security Card:*

Applicant Date of Birth and Social Security Number with Legal Name are required to run background checks. This information will be kept confidential.

Please upload your resume:*

REFERENCES

List three persons not related to you who can judge your qualifications for this position. One of whom must be affiliated with GEM CULTURE. They should have known you for at least one year. Names and Phone numbers only.

Name*

First NameLast Name

Phone Number*

Please enter a valid phone number.

Name*

First NameLast Name

Phone Number*

Please enter a valid phone number.

Name*

First NameLast Name

Phone Number*

Please enter a valid phone number.

Please answer all of the following questions as completely as possible.

STATEMENT OF INTEREST: Why do you want to become a Guest GEM Mentor? *

Do you have any previous experience volunteering or working with youth? If so, please specify.*

What area(s) of expertise, qualities, skills, or other attributes do you feel you have that would benefit a youth? Please explain. *

Have you or anyone in your household been convicted of a crime (other than minor traffic violations)? *

If yes, please state offense, date, state and country below (a conviction record will not necessarily be cause for disqualification.):

I verify that there is no registered sex offender residing in my home. insert your initial*

This is an application in GEM Mentoring for which there is no monetary compensation. There shall be no discrimination against an otherwise qualified individual. I understand that a background check will be done using my DOB/SS# (date of birth/social security number). This information will be kept confidential.

I certify that all information provided on this application is true and complete. I understand that falsification or significant omissions of any information may be considered justification for non-acceptance or dismissal if discovered at a later date.

I have read the description for the position for which I am applying. If appointed, I agree to fulfill the position requirements.

Signature*

Today's Date*

Date

Referred By:*