CAPS Mentor Application

Contact Information
Please find additional CAPS Mentorship Program Information here:
Name*

First NameLast Name
Preferred Name
Preferred Pronouns*
Age*
Email*
Phone Number*
How did you hear about CAPS?*

BCNC WebsiteReferral from current or previous BCNC StaffReferral from BCNC's Partner Organization/ CompanyReferred by a friend or family memberSearch engine (e.g., Google, Bing)Social media (e.g., Instagram, Facebook...)Other
Please Specify:
Are you familiar with the U.S. College application and/or Financial Aid application process?*

Yes, I have gone through the process myself.Yes, I have experience helping young adults through the application process.I have some knowledge of the process, but not the specificsNoOther (please specify)
Recent Education & Professional Experience
What is the highest level of education you have completed?*
What is the name of your undergraduate college or university?*
What was your undergraduate major and year of graduation?*
Current Company/Agency*
Job Title*
Years in Current Position*
Other Relevant Work/Education Experiences (i.e. grad school, part-time, volunteer experiences)
If you have a resume, feel free to upload it here (optional, but helpful).

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Language Capacity
Please indicate what language(s) do you speak, write, read, and/or understand, as well as your level of proficiency. *
Emergency Contact
Emergency Contact Name*
Relationship to you*
Emergency Contact Phone Number*
For Mentor-Mentee Match Purposes
Do you have experience working with youth?*
Please provide a short description of your experience working with youth:*
Do you have any volunteer/community service experience?*
Please provide a short description of your volunteering/community service experience:*
What are your interests and hobbies?*
My friends describe me as _________.*
I work best with youth who are _____________.*
Do you have any accessibility needs that staff should be mindful of?*
Boston Chinatown Neighborhood Center, Inc. (BCNC) values your participation and privacy as a program participant. BCNC treats personal data as strictly confidential. Data is not disclosed to parties who have not signed a Disclosure / Confidentiality Agreement unless authorized by federal mandate. Data is stored in confidential and secure platforms and accessible only by authorized personnel.
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Contact Information

Recent Education & Professional Experience

Language Capacity

Emergency Contact

For Mentor-Mentee Match Purposes