• 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

  • 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.)
  • 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?
  • 0/32768

  • Personal Information

  • Pronouns (please select all that apply to you)
  • Gender Identity (please select all that apply to you)
  • Date of Birth
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.

  • Mentorship Motivation and interest

  • 0/32768

  • Background Experience

  • 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

  • Format: (000) 000-0000.

  • Social Media Screening

  • For all social media sites selected please list profile name(s), link(s), or username(s)

  • Social Media Accounts

  • References

  • List 3 personal references. Include Name, Phone Number, and Email

  • 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

  • Demographics

  • You may choose whether or not to answer on all questions. These are gathered for the purpose of getting a better understanding of the community we are serving and for grant writing. Many grants require knowing more about the demographics we serve and whether or not their mission also serves similar intersections to community such as race, economic class, and family size. Some questions are required in order to process a background check.

  • Race or Ethnicity (please select all that apply)
  • Romantic or Sexual Orientation
  • Should be Empty: