B2H Mentor Applicaiton
This application will take an estimated 15-20 minutes to complete and will require photograph proof of Driver License and Auto Insurance. Before you start this application, please have both of those ready.
Name
*
First Name
Last Name
Pronouns
*
She/Her
He/HIm
They/Them
I do not wish to disclose at this time
Other
Gender Identity
*
Male
Female
Non-Binary
Prefer Not To Say
Transgender
Decline To Answer
Other
Sex
*
Male
Female
Race
*
White
Black or African American
Native American/ Alaskan
Asian
Native Hawaiian/ Pacific Islander
Bi- Racial
Other
Date of Birth
*
-
Month
-
Day
Year
Date
Prefered Phone Number
*
Please enter a valid phone number.
Is this a mobile phone capable of receiving text messages?
*
Yes
No
Do you have an alternate phone number?
Yes
No
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Check 5 Items In which You Believe You Would Be Able To Best Offer Your Mentee
*
Productive Advice
Emotional Support
Exposure to New Experiences or Opportunities
Academic Support
Life Skills
Self Discovery
Navigating Conflict
Job Search
Emotional Regulation
College Search
Connect With Resources
Be a sounding Board/ Effective Listening
Other
What values are important to you, and how might they help you support and connect with a teen who is system impacted?
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What drives your commitment to mentoring with HOPE585/B2H? *
*
What are you looking to accomplish as a mentor, both for your mentee and for your own personal growth?
*
Do you feel confident in your ability to connect with and support youth from diverse communities, including various cultures, religions, and lifestyles?
*
Yes
No
Maybe
Other
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Personal Experience
We want to establish teams that have complimentary schedules, similar passions or interests, andvaluable resources or experiences that could benefit everyone involved. The information on thisapplication helps us accomplish these goals.
Have you ever been a foster parent?
*
Yes
No
Have you ever lived in alternative housing arrangements (Foster Care, Group Home, Shelter, With Relative, Adoptive Parents?
*
Yes
No
Please Share
*
Please share what you are comfortable with about your experience in alternative housing.
Do you have any personal or professional experience with the foster care system, adoption process or other systems that impact individuals in marginalized or underserved communities?
*
Yes
No
Please Share
*
Please share your experience.
Have you previously been involved in a mentorship program or worked with a youth-serving organization?
*
Yes
No
Please Share
*
Please share your experience.
Do you have any experience with informal youth mentorship?
*
Yes
No
Please Share
*
Please share your experience.
In your own words, what makes you a great fit to mentor a young person?
*
How comfortable are you mentoring a youth who expresses a gay, lesbian, transgender, or other LGBTQ+ identity?
*
Comfortable
Not Comfortable
Open for further discussion
Would you like to disclose any personal history with substance use or addiction that may be relevant to your role or support at Hope585?
*
Yes, I would like to share
No, I would not like to share at this time
Please Share
*
Please share what you are comfotable with sharing at the moment.
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Personal Interests
Are you applying to be a motor with a group of people you already do life with or as an individual?
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Group
Individual
How do you prefer to communicate (check all that apply)
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Call
Text
In Person
Social Media
I use the following social media platforms (Check All That Apply)
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Facebook
Instagram
Snap Chat
Tik Tok
Twitter (X)
LinkedIn
Other
Three words that I think describe me are:
*
For me, the things that matter most in life are:
*
What kind of support would you have wanted/needed as a teen?
*
In my free time I like to: (Check all that apply & be descriptive and specify in the descriptions as this is what we use to match you with a mentee and want to ensure a perfect fit).
*
Rows
Agree
Describe
Play/ Watch Sports
Watch TV/ Movies
Play Music
Listen to Music
Read
Play Video Games
Draw/ Paint
Write/Journal
Shop
Eat
Cooking
Craft
Run/Hike
Nature Based Activities
Traveling
Photography/ Social Meida
Other:
What is your T-Shirt size (unisex)?
XS
Small
Medium
Large
XL
2XL
3XL
Other
How did you hear about HOPE585?
*
Word of mouth
Lunch & Learn
Staff/Board member
Facebook/Social Media
TV or Article
Website
Email
Church/CarePortal
Upload Documents
Please upload a photo that best represents your personality
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please upload the front of your drivers license
*
Browse Files
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of
Please upload the back of your drivers license
*
Browse Files
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of
Please upload the proof of auto insurance
*
Browse Files
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Choose a file
Cancel
of
Submit
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