Become a Mentor Application
Apply to mentor with The Village Project. Please complete all required questions so we can learn about your background, availability, fit, and readiness for screening. The form is designed to be welcoming, inclusive, and easy to complete on mobile devices.
Personal & Contact Information
Full Legal Name
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First Name
Middle Name
Last Name
Preferred Name
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Email Address
*
example@example.com
Mobile Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
City
*
County
*
State
*
ZIP Code
*
Preferred Method of Contact
*
Please Select
Text
Phone
Email
Current Occupation
*
Employer / Business / Organization
Background & Personal Story
Brief background: professional, educational, trade, military, entrepreneurial, or other
*
Tell us a little about yourself
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Interests and hobbies
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Sports
Gaming
Technology
Coding
Music
Reading
Fitness
Outdoor Activities
Arts & Crafts
Cooking
Travel
Community Service
Other
Skills, professions, trades, hobbies, or experiences you would enjoy sharing with a young man
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Experiences or opportunities you could potentially expose a mentee to through your profession, business, hobbies, or community involvement
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Life experiences that have shaped the man you are today
*
Motivation & Mentoring Philosophy
Why do you want to become a mentor?
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What do you believe a mentor's role should be in a young man's life?
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What do you believe you can offer a young man beyond career or professional advice?
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What do you hope you will gain or learn through the mentoring experience?
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One year from now, what would you hope a mentee says about the difference you made?
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Was there a man who made a meaningful difference in your life when you were young? If so, what did he do that mattered?
Scenario / Judgment Questions
How would you approach the conversation if a young man you are mentoring makes a decision you strongly disagree with?
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What would you do if your mentee seems quiet, gives short answers, and does not appear interested in building a relationship?
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Mentee Match & Fit
What age group(s) would you feel comfortable mentoring?
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10–12
13–15
16–18
18–21
No preference
Are there particular interests, goals, personalities, or experiences that would help you connect especially well with a young man?
Experience with Youth
Have you worked with or mentored young people?
*
Please Select
Yes
No
If yes, briefly describe your experience with young people
Format, Availability & Commitment
Preferred mentoring format
*
Please Select
One-on-one
Group mentorship
Both
Preferred interaction
*
Please Select
In person
Virtual
Combination
No preference
How often can you realistically commit to meaningful contact with a mentee?
*
What days and times generally work best for you?
*
Will you participate in periodic Village Project group activities?
*
Please Select
Yes
No
How far are you willing to travel for in-person mentoring?
*
Please Select
Up to 10 miles
Up to 25 miles
Up to 50 miles
More than 50 miles
Virtual mentoring only
Can you commit to maintaining regular contact for at least six months?
*
Please Select
Yes
No
I'm not sure yet
Are there any upcoming circumstances that could affect your availability in the next six months?
*
Please Select
Yes
No
If yes, please describe those circumstances
What does 'showing up consistently' mean to you?
*
Screening, Safety & Consent
Willing to verify identity
*
Please Select
Yes
No
Willing to undergo a criminal background check
*
Please Select
Yes
No
Willing to undergo a sex-offender registry screening
*
Please Select
Yes
No
Willing to provide at least two personal or professional references
*
Please Select
Yes
No
Willing to participate in a brief mentor interview and orientation before matching
*
Please Select
Yes
No
Have you ever been convicted of, pleaded guilty/no contest to, or received deferred adjudication for a criminal offense other than a minor traffic violation?
*
Please Select
No
Yes
If yes, briefly explain the nature of the offense and approximately when it occurred
Have you ever been investigated, disciplined, suspended, terminated, removed, or asked to resign from a position due to allegations involving inappropriate conduct, abuse, harassment, violence, exploitation, or boundary violations involving a minor?
*
Please Select
No
Yes
If yes, briefly explain the situation and when it occurred
Anything else in your background we should know
References (Two Required)
Reference 1 Full Name
*
First Name
Middle Name
Last Name
Reference 1 Relationship
*
Reference 1 How Long You’ve Known Them
*
Reference 1 Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Reference 1 Email Address
*
example@example.com
Reference 2 Full Name
*
First Name
Middle Name
Last Name
Reference 2 Relationship
*
Reference 2 How Long You’ve Known Them
*
Reference 2 Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Reference 2 Email Address
*
example@example.com
Agreements & Acknowledgements
Agreements & Acknowledgements
*
I agree
I acknowledge
I authorize
I have read these expectations and agree to follow them
*
I agree
I certify the information is accurate to the best of my knowledge
*
I acknowledge
I understand submitting an application does not guarantee acceptance
*
I acknowledge
I understand approval may require additional screening, reference checks, interview, orientation, and background check
*
I acknowledge
I authorize The Village Project to contact me and the references I provided regarding my mentor application
*
I authorize
Signature & Final Details
Typed Full Legal Name
*
First Name
Middle Name
Last Name
Electronic Signature
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit Application
Submit Application
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