Redefine Mentorship Program Application - Mentor Application
Thank you for your interest in becoming a mentor in our mentorship program. Please complete the following application thoroughly and prayerfully.
Personal Information
Full Name:
*
First Name
Last Name
Date of Birth:
-
Month
-
Day
Year
Date
Phone Number:
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address:
*
example@example.com
Mailing Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How Did You Hear About This Program?
Church Announcement
Friend/Family
Social Media
Website
Other (please specify in next question)
Other (please specify):
Why do you want to become a mentor for Redefine Mentors Program? (Please share your heart and purpose for joining this mentorship journey.)
*
Do you have any previous mentoring, teaching or discipleship experience?
Yes
No
If you have experience, please briefly describe it below.
Select your preferred age group to mentor:
Children (Ages 7-12)
Teens (Ages 13-18)
Young Adults (Ages 19-25)
Adults (25+)
No preference
Provide your availability for mentoring sessions.
*
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Your Faith Journey/Testimony
Please share a brief version of your personal story of faith, how you came to know Jesus, and how you’ve grown in your walk with Him.
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Consent for Background Check
Because we value the safety and spiritual well-being of all participants, we require background checks for all mentors working with minors.
Do you consent to a background check?
Yes
No
Full Legal Name (for background check):
Driver’s License/ID Number (optional unless required for check):
State of License/ID Issued:
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References
Please list two personal or pastoral references.
Reference #1
First Name
Last Name
Reference #1 relationship:
Pastoral
Personal
Reference #1 contact information (phone/email):
Reference #2
First Name
Last Name
Reference #2 relationship:
Pastoral
Personal
Reference #2 contact information (phone/email):
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Commitment Agreement
By submitting this application, I understand that mentoring is a spiritual commitment to guide others with humility, wisdom, and love, rooted in the teachings of Jesus Christ. I agree to uphold the values of this ministry and serve with integrity and grace.
Signature
Date
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Month
-
Day
Year
Date
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