LBN Mentor Application Form Fall 2025

LBN Mentor Registration Form
Please note: You must be at least 15 years old or in Grade 10 to apply. If you do not meet either of these requirements, you must have one of your teachers fill out a Volunteer Referral Form.

Before you begin your application, we recommend watching this short video, which outlines the application process and what we expect from our mentors.

Please only submit one application form per person - do not submit another application on another account, as this interferes with volunteer placement. Thank you for understanding.
In this form, you will enter the following information:
- General information (Name, Date of Birth, Email Address, etc.)
- Education information
- Emergency contact
- Demographic information
- Position Preference (Reading/Math)
- Your availability
- Work and related experience
- Consent to onboarding documents

General Information:
Full Name*

First Name (Legal)Preferred First Name (if different from legal name)Last Name (Legal)
Province/Territory*
Date of Birth*

MonthDayYear
Date
Age*
Pronouns
Contact Information:
Phone Number*
Preferred Email Address (for all LBN communications)*

Confirmation Emailexample@example.com
Would you like to receive our newsletter by email?*

YesNo
Gmail Address (must contain the word "gmail," as our materials are shared through Google Drive)*

Confirmation Emailexample@gmail.com
Please enter a valid Gmail address that contains the characters "@gmail.com"

Education Information:
School Name*
Years Attended (e.g. 2018-2022)*
Major (if applicable)
Are you in Grade 10 or above?*

YesNo
If you are not currently enrolled in school, do you plan to return in the future?*

YesNoUnsure

Emergency Contact:
Emergency Contact Name*

Emergency Contact First NameEmergency Contact Last Name
Emergency Contact Email*
example@example.com
Emergency Contact Number*
Please enter a valid phone number.

Position Preference:
Mentor Responsibilities and Requirements
Mentor Responsibilities:

We prepare and support you to make a difference in a child's life. To be a successful mentor, you are responsible for the following:
- Complete the math/reading volunteer training sessions
- Participate in the orientation during the first week of the programs
- Attend at least 90% of program sessions
- Prepare lesson materials provided by the organization for each session
- Mentor your little buddy by using the lesson materials prepared
- Track your little buddy’s progress
- Complete mentor reports
- Respond to emails and Slack messages
Requirements:
- Applicants must be either enrolled in school or planning to attend
- You must be at least 15 years old or in Grade 10 to apply. If you do not meet either of these requirements, you must have one of your teachers fill out a Volunteer Referral Form
- The mandatory training must be completed
- Must be located in Canada or the Continental United States
- Volunteers must complete a simple criminal record check form through LBN before volunteering with children
Time Commitment
- Around 5-6 hrs/week throughout the program term
- 2-3 hrs total to complete asynchronous training modules
Program Preference
Please select all that apply.
Program Preference Options*

Reading MentorMath Mentor
Are you a returning mentor?*

Yes, I have volunteered for at least one term and have completed an interviewNo

Work and Related Experience:
Please tell us a bit about yourself. Why do you want to volunteer with us? Please share any experience you have which is relevant to the position for which you are applying. This does not need to be "professional" experience, it can be any experience you feel is relevant. If you are a returning mentor, you may put N/A.*
If you are a returning volunteer, you may put N/A.

Please read and sign below:
Note: All the forms below are based on our Volunteer Manual. Please give the manual a thorough read before proceeding with this form.
1) Letter of Understanding
I have read and understood the LBN Volunteer Manual. My signature below indicates that I agree to and will abide by all the standards described herein, and with all other policies and procedures of the Learning Buddies Network of the Lower Mainland Society as communicated to me from time to time.
Volunteer Initial*
By signing, I hereby acknowledge that I understand.
Date*

MonthDayYear
Date

Please read and sign below:
Note: All the forms below are based on our Volunteer Manual.
2) Video Release Agreement
LBN would like the opportunity to take photos and videos of participants for our newsletters or for stories about LBN. Do you (and your parent/guardian, if you are under 18) consent to your inclusion in photos and videos of sessions?*

YesNo
Volunteer Signature*
By signing, I hereby acknowledge that I understand.
Date*

MonthDayYear
Date
Parent Signature
By signing, I hereby acknowledge that I understand.
Date

MonthDayYear
Date

Please read and sign below:
Note: All the forms below are based on our Volunteer Manual.
3) LBN Mentor Agreement
I understand that LBN can terminate my volunteer engagement should I fail to fulfill my responsibilities as a mentor and the agreements listed above. By signing below, I agree to the terms of this volunteer agreement.
Volunteer Signature*
By signing, I hereby acknowledge that I understand.
Date*

MonthDayYear
Date
By submitting this application form, I understand what is expected of me and that I will be asked to commit an average of 5-6 hrs/week to LBN's programs. Attendance at 90% of the sessions is required.*

I understand
Thank you for all your support of our programs. Without volunteers like you, we could not support children who need our services most.

Sincerely,

Owen Fan, Executive Director
owen@learningbuddiesnetwork.co m
Please click Review Responses to check your answers on the next page and then click the green "Submit" button to confirm your registration form.
Should be Empty:

	First Choice	Second Choice	Third Choice	Possibly	Unavailable
Mosaic Family Centre - Tuesday 4:15-6:00 pm
Sunset Community Centre - Thursday 3:45-5:45 pm

	First Choice	Second Choice	Third Choice	Possibly	Unavailable
Kingswood Elementary School - Tuesday 3:15-5:00 pm
Westridge Elementary School - Wednesday 3:15-5:00 pm
David Lloyd George Elementary School - Wednesday 3:15-5:00 pm
Moberly Elementary School - Thursday 3:15-5:00 pm
Clayton Heights Secondary School - Tuesday & Thursday 2:52-4:15 pm
Johnston Heights Secondary School - Tuesday & Thursday 2:55-4:00 pm
James Whiteside Elementary School - Tuesday 3:15-5:00 pm

LBN Mentor Registration Form