2024 - 2025 Mentor Application

Mentor Application

Please complete all information and answer all questions. Only complete forms will be processed! All information provided remains confidential and is used for both safety and funding purposes.
Personal Information
Full Name*

First NameLast Name
Birth Date*

MonthDayYear
Instagram Name*
Current Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
This is my:*
E-mail*
College/University
T-Shirt Size:*

Evidence of Community / Campus Involvement

Please provide relevant information, with most recent position held first.
Title of Community Service or Program:
Start Date:
(Mo/Yr)
Location:
Goal of Community Service or Program:
Please describe your specific involvement:
Title of Community Service or Program:
Start Date:
(Mo/Yr)
Location:
Goal of Community Service or Program:
Please describe your specific involvement:
Title of Community Service or Program:
Start Date:
(Mo/Yr)
Location:
Goal of Community Service or Program:
Please describe your specific involvement:

Application Questions

Please answer all of the following questions as completely as possible.
1. Why do you want to become a mentor with the G.I.R.L.S. Club?*
2. Describe any previous experience volunteering or working with youth.*
3. What qualities, skills, or attributes do you feel you have that would benefit a youth? Please explain.*
4. Can you commit to participate in the G.I.R.L.S. Club for a minimum of one year?*
5. Are you available to meet with a mentee for a minimum of five hours pr month and have contact at least once per week? Please explain any particular scheduling issues.*
6. Which type of mentorship are you interested in?

One-on-One MentoringGroup Mentoring
7. Please indicate the amount of volunteering you are interested in for the year (check one).

Less than 5 hours5 hours10 hours20 hours40 hoursYear-Long
8. If year-long, are you willing to communicate regularly and openly with program staff, provide monthly information regarding your mentoring activities, and receive feedback regarding any difficulties during your participation in the mentoring program?*
9. Describe yourself using three adjectives.*
10. How would your friends, family, and co-workers describe you?*
11. Have you ever been convicted of a crime? If so, what were the circumstances?*
12. Have you ever used illegal drugs? If so, what substances were used and how often?*
13. Have you ever been investigated or convicted of child abuse or neglect? If yes, please explain.*
14. Are you willing to attend an initial mentor training session and two in-service training sessions per year?*
15. Are you interested in pledging a sorority in the near future?*

Please read carefully before signing:

G.I.R.L.S. Club appreciates your interest in becoming a mentor.

Please select from each of the following.
I agree to follow all mentoring program guidelines and understand that any violation will result in suspension and/or termination of the mentoring relationship*
I understand that G.I.R.L.S. Club is not obligated to provide a reason for the decision in accepting or rejecting me as a mentor.*
(optional) I agree to all G.I.R.L.S. Club to use any photographic image of me taken while participating in the organization. These images may be used in promotions or other related marketing materials.
I understand I must return all of the following completed items along with this application, and that any incomplete information will result in the delay of my application being processed.*
Copy of your valid driver's license and proof of insurance Personal Reference Form Interest Survey Form Criminal History Release Form
I understand that I must complete a background check before I can be matched with a mentee.*
I understand that I must communicate with my mentee(s) weekly and initiate outings outside of the regular meetings.*
I understand that I will be required to fundraise (2x) to help support the mission of the organization.*
I understand that I have the option to serve on sub-committees within the organization.*
By signing below, I attest to the truthfulness of all information listed on this application and agree to all above terms and conditions.
Signature:*

Clear
Today's Date*

MonthDayYear

Personal Reference

Please list three references whom you would like to use as character references (only people you have known for at least a year). Include at least one relative and one supervisor. Any information G.I.R.L.S. Club gathers from these references will be held as confidential and not released to you, the applicant.
a.) Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
How long known:*
b.) Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
How long known:*
c.) Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
How long known:*
Affirmation: The above information is true to the best of my knowledge. I grant permission to contact my references provided.
Signature*

Clear
Today's Date*

MonthDayYear

Mentor Interest Survey

Please complete all of the following. This survey will help G.I.R.L.S. Club know more about you and your interest.
1. What are the most convenient times for you to assist with a mentee? Check all that apply.*

WeekdaysAfterschoolEveningsWeekends
2. Please indicate which age group you are interested in working with:*

4th - 5th gradeMiddle SchoolHigh School
3. What are some of your favorite things to do with other people?*
4. What are your favorite subjects to read?*
5. What is your occupation and or major? How did you choose this field?*
6. What is one goal you set for the future?*
7. If you could learn something new, what would it be and why?*
8. Who do you admire most and why?*
9. Describe your ideal Saturday.*
Should be Empty: