Jump Start Compass Program – Mentor & Chaperone Application

Full Name*

First NameLast Name

Preferred Name

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Email Address*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Age (Must be 21 or older)*

Occupation / Current Role*

Employer or Organization (if applicable)

Are you available to attend monthly sessions (typically the 4th Saturday of each month) from February–November 2026?*

If you answered "no" please provide the dates when you will not be avaiable.

Are you available to participate in the week-long college/experiential tour, that will be in Fall 2026?*

Are you willing to commit to at least two intentional touchpoint per month (check-in, conversation, encouragement) with students you are assigned to?*

Do you understand that this role requires consistency, professionalism, and reliability throughout the program year?*

Please describe any prior experience working with youth or young adults (formal or informal).*

What draws you to mentoring high school students?*

Have you ever served in a mentorship, coaching, teaching, or leadership role? If yes, please describe.*

In your own words, what does being a positive adult presence for a young person mean to you?*

Compass emphasizes leadership, accountability, safety, and growth. Which of these areas do you feel most equipped to support, and why?*

How do you approach building trust with young people?*

A student in your group has stopped participating and seems disengaged. How would you respond?*

A student shares something personal or challenging with you. How do you handle the situation while maintaining appropriate boundaries?*

If you notice a student consistently missing sessions or struggling with commitment, what steps would you take?*

Do you understand and agree to: - Maintain appropriate adult/youth boundaries - Follow all program safety protocols - Refrain from one-on-one unsupervised situations outside of program guidelines - Report concerns to program leadership*

Are you willing to complete any required: - Background check - Training or orientation - Safety briefing*

How do you prefer to communicate? (Select all that apply)*

How do you manage your time and commitments to ensure reliability?*

The week-long college tour requires extended supervision, teamwork, flexibility, and adherence to safety protocols. Are you willing and able to fulfill these responsibilities?*

Please share any experience you have traveling with youth or groups (if applicable).

Please provide one professional or character reference (name, relationship, phone/email).*

Why do you believe you would be a good fit as a Compass Mentor/Chaperone?*

Is there anything else you would like us to know about you?

For this role, we are only looking to fill 4 positions. If you are not selected for this role specifically, are you still open to being a volunteer mentor that joins hands with us in fulfilling the organization’s mission?*

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