Kyler's Connections Mentor Application

Kyler's Connections

Mentor Application
This application is for all adults wishing to be a Kyler's Connections Mentor. For questions please email us at Mentorships@transfamilysos.org
Email
example@example.com

Eligibility and Mentorship Screening
How long have you been transitioning (This is not confined to medical transition, but whenever you would mark as beginning to live as your authentic self.)

Less than 1 Year1 - 2 Years2 - 3 Years3 -4 Years5 or more years
Have you been integrated into the world with this identity for at least one year?
To be a mentor, we will require you to complete a background check, attend training sessions, and commit to at least one year of mentoring. Do you agree to these terms?

YesNo
Please describe why you would like to be a mentor

0/32768

Mentorship Motivation and interest
Please describe what your strengths as a mentor would be
Describe your interests and/or hobbies
What role do you think your physical or mental health would play in your mentorship?
Mentorship structure preference
What would have helped you?

0/32768

Background Experience
Work Experience
Please describe any current employment, past employment, or other paid work experience. This will help us match mentees that may have similar career interests.
Community experience
Describe any current or past involvement (including both volunteer and participant experience) in community organizations, clubs, support groups, or other groups. We are especially interested in experience with LGBTQ+ community groups.
Educational Experience
Describe your current or past educational and academic experience. Please include both the level of education achieved and primary areas of study. This will be used to help match you with potential mentees with similar areas of interest.
Additional Professional or Academic Background
Please any additional professional or academic areas where you have experience that you would like to share.
What else would you like us to know?

0/32768

Emergency Contact
This information will only be used in the case that there is an immediate safety concern for you AND we are unable to contact you directly. We will only share the necessary information in contacting this person. If you have any questions regarding the use of emergency contacts and what that conversation might look like, please contact our coordinator at mentorships@transfamilysos.org
Emergency Contact First Name
Emergency Contact Last Name
Emergency Contact Phone Number
Please enter a valid phone number.
Emergency Contact Relation to You
Use name/pronouns
What name/pronouns should we use
Anything else you'd like to tell us

Social Media Screening
For all social media sites selected please list profile name(s), link(s), or username(s)
Social Media Accounts

FacebookBlueskyInstagramMastodon / FediverseTumblrYoutube ChannelOther
Facebook Handle
Instagram Handle
Youtube Channel
Tumblr

Mentor-to-Mentor Contact Information Release
This allows mentors to support each other within the mentorship program. Sharing of contact information with other mentors is not mandatory. It is encouraged
Consent for background check?
Do you consent to allow TransFamily Support Services and/or Kyler's Konnections to share your contact information with other mentors?

Kyler's Connections