Silver Lining Mentoring (SLM) e-Mentoring Mentee Sign Up!

Silver Lining Mentoring’s e-Mentoring program uses a virtual platform for mentors and mentees to connect by video and text. Using an app, the mentor and mentee will have all the tools they need to build a strong relationship, work on goals, and grow social networks easily from their phones or devices. Through regular virtual check-ins, mentors will help mentees build essential skills, find helpful resources, and feel more connected—all while forming a supportive, lasting relationship over at least 12 months. Learn more on our e-Mentoring program webpage!

Privacy Policy Statement:

To protect participant safety, evaluate effectiveness and make continuous program improvements, Silver Lining Mentoring collects demographic and survey information from the participants in our services. Information is entered into a secure database, Salesforce, that can only be accessed by program staff at Silver Lining Mentoring. Silver Lining Mentoring will never share a mentee's personal information without explicit consent.
Privacy Statement Acknowledgement
Guardianship Acknowledgement
Legal Guardian's First Name
Legal Guardian's Last Name
Legal Guardian's Mailing Address Street
Legal Guardian's Mailing Address City
Legal Guardian's State/Province
Legal Guardian's Zip/Postal Code
Legal Guardian's Email Address
example@example.com
Legal Guardian's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Email Address
example@example.com
Emergency Contact Relationship to You
e-Mentoring Program Acknowledgements
How did you hear about this program (from which organization, group, person, etc.)?

Part 2: e-Mentoring Mentee Policy Agreement
I agree to each of the following:
1. I understand that I’m expected to meet with my mentor for at least one year with the intention to remain matched for as long as it is in my best interest.
2. I will speak with the Silver Lining Team and with my mentor as soon as possible if there are any problems or if my match needs to end for any reason.
3. I will be available to communicate with my mentor, on average, at least once a week for 10-60 minutes (totaling up to 4 hours each month as needed)
4. I will inform Silver Lining Mentoring and my mentor if my digital contact information changes, including my phone number and email.
5. I will do my best to keep myself and my mentor safe by minimizing risky behaviors and informing my mentor or SLM if I feel unsafe at any time.
6. I understand that mentors are not allowed to share personal information about me with the SLM staff unless the mentor has a concern about safety. In these cases, the mentor will notify the appropriate person at SLM of their concernS
  
  I have read this document and promise to abide by it.
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
SLM ID
Guardianship Status
Should be Empty:

Emergency Contact

Part 1: Demographic Details

Part 2: e-Mentoring Mentee Policy Agreement