Morton Mentor Application
Basic Information
Tell us a little about you.
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Gender
*
Male
Female
Date of Birth
*
-
Month
-
Day
Year
Date
Career Information
Tell us a little about your place of employment and education. This will help us match you with a student with similar interests.
Business Name
*
Job Title
*
Career Category - Please select the category(ies) that best describes your career.
*
Agriculture, Food, & Natural Resources
Architecture & Construction
Arts, A/V Technology & Communications
Business Management & Administration
Education & Training
Finance
Government & Public Administration
Health Sciences
Hospitality & Tourism
Human Services
Information Technology
Law, Public Safety, Corrections, & Security
Manufacturing
Marketing
Science, Technology, Engineering, & Mathematics
Transportation, Distribution, & Logistics
Other
If "Other" from above, please explain.
University or College
*
Field of Study
*
Other Interests (Fields of Study Willing to Mentor)
Degree Level
*
Associates
Bachelors
Masters
Doctorate
Trade School
Background Check
There are a few things we HAVE to make sure of, just in case.
Have you been convicted as a child sex offender?
*
Yes
No
If yes, please provide more information.
Have you ever been convicted of a felony?
*
Yes
No
If yes, please provide more information.
Are you willing to consent to a criminal history records check? (This will be provided at no cost to you and is a requirement of Morton High School for working with underage students).
*
Yes
No
Documentation
Please read and complete the following.
Signature
*
Date of Signature
*
-
Month
-
Day
Year
Date
Please name any children currently enrolled at Morton High School:
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Should be Empty: