POWERHOUSE MENTOR INQUIRY
Thank you for your interest in becoming a mentor with the Powerhouse Mentor Program. We look forward to contacting you within 48 hours of your submission.
Name
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Why are you interested in becoming a mentor?
Why do you believe the mentoring role is important?
What is your career field?
What are your interests and hobbies?
What motivates you?
What age range between 9 to 18 years of age would you like to mentor?
Are you willing to have a Background Check completed prior to mentoring?
Yes
No
Are you willing to attend quarterly in service training?
Yes
No
Are you willing to be an advocate for mentoring youth by recruiting other mentors?
Yes
No
Are you available to spend 8 hours a month with a mentee?
Yes
No
Submit
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