I, *, understand it will be necessary for Team Up Connections Mentoring Program to conduct a background check regarding my driving record, criminal history, personal references, and employment.I authorize Team Up Connections to obtain any needed information regarding my driving record, legal/criminal history, character references, and employment from any state or federal agency, my employer, and personal references for the purposes of participating in a mentoring program. Further, I provide permission for Team Up Connections to conduct the same investigation of my background in previous states in which I have resided.Further, I understand that information about myself will be anonymously (without my name) shared with a prospective mentee(s) and his/her parent(s)/guardian(s) to aid in determining a suitable match. Once a mentor/mentee match is determined, my identity and any other information known about me may be shared with the mentee and parent/guardian to ensure and aid in facilitating a safe and successful match relationship.
Please complete all of the following. This survey will help Team Up Connections Mentoring Program know more about you and your interests and help us find a good mentee match for you.
I, *, certify that I have given true, accurate, and complete information on this form to the best of my knowledge. In the event confirmation is needed in connection with my work, I authorize educational institutions, associations, registration, and licensing boards, and others to furnish whatever detail is available concerning my qualifications. I authorize investigations of all statements made in this application and understand that false information of documentation, or a failure to disclose relevant information may be grounds for rejection of my application, disciplinary action, or dismissal if I am employed, and (or) criminal action. I further understand that dismissal on unemployment shall be mandatory if fradulent disclosures are given to meet position qualifications.