Mentor Application
Please answer the following questions as truthfully as possible. This application will only be seen by Trusted Mentors Staff. Trusted Mentors is an inclusive organization that strives to serve the needs of all residents of Marion County. We do acknowledge everyone's individual beliefs. We will make every effort to match according to your preferences.
Current Date
-
Month
-
Day
Year
Date
Full Name
Mr.
Ms.
Mrs.
Dr.
Prof.
Rev.
Prefix
First Name
Middle Initial or Name
Last Name
Suffix
Date of Birth
*
/
Month
/
Day
Year
Date
Age
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone Number
Format: (000) 000-0000.
Mobile Phone Number
Format: (000) 000-0000.
Preferred Phone
*
Home
Mobile
Phone Preference
Call
Text
Email
*
example@example.com
Demographic Information
To assist with matching, please answer the following:
Race:
*
African American
Asian
Caucasian
Hispanic/Latino
Hawaiian / Pacific Islander
Native American
Multi-Racial
Other
How do you identify?
*
Man
Woman
Transman
Transwoman
Non-Binary
Other
Please indicate preferred pronouns:
*
He/Him
She/Her
They/Them
He/They
She/They
Other
Are you comfortable interacting with the LGBTQIA+ community?
*
Yes
No
Other
Have you or a family member ever served in the military?
*
Yes
No
Do you have children?
*
Yes
No
Primary Language:
*
English
Spanish
German
Other
Other Languages Spoken:
Spanish
German
Haitian Creole
Arabic
Chinese
Japanese
Other
Marital Status:
*
Single
Married
Divorced
Separated
Widowed
Domestic Partner
Common Law
Are you a member of the LGBTQ+ community?
Yes
No
Would you prefer to mentor someone from the LGBTQ+ community?
Yes
No
Either
If yes, how do you identify?
Lesbian
Gay
Bisexual
Transgender
Queer
Pansexual
Other
Is faith/spirituality an important part of your life?
Yes
No
Would you prefer to mentor based on faith/spirituality?
Yes
No
Either
If yes, what is your faith tradition?
Christian
Buddhist
Catholic
Hindu
Jewish
Muslim
Other
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Activities and Hobbies
What are your interests? (Please select your top two or three in each category.)
GENERAL
Arts/Crafts
Dance
Movies
Reading
Shopping
Drama
Board Games
Pet
Cooking
Eating Out
Computer Games
TV
Fashion
Writing
Video Games
Travel
PLAYING SPORTS
Basketball
Golf
Martial Arts
Track/Field
Baseball
Gymnastics
Soccer
Volleyball
Cheerleading
Hockey
Softball
Wrestling
Football
Lacrosse
Tennis
Other
WATCHING SPORTS
Basketball
Golf
Martial Arts
Track/Field
Baseball
Gymnastics
Soccer
Volleyball
Cheerleading
Hockey
Softball
Wrestling
Football
Lacrosse
Tennis
Other
CULTURAL EVENTS
Theater
Concerts
Museums
Other
OUTDOOR ACTIVITIES
Biking
Ice Skating
Walking
Hiking
Boating/Canoeing
Rollerblading
Skiing
Running
Fishing/Hunting
Skateboarding
Snowboarding
Other
MUSIC
Listening to Music
Playing an Instrument
Singing
Other
ADDITIONAL COMMENTS / QUESTIONS
Please sign me up for your eNewsletter.
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Congratulations and Welcome!
Applying to mentor in the Trusted Mentors program is the first step towards helping someone move toward independence and self-sufficiency. Trusted Mentors believes and follows mentoring best practices. One such practice is good screening which includes selecting mentors who can maintain the commitment required and achieve the stated mission and goals of Trusted Mentors. After completion of this application, a personal interview will be conducted. Also, if you intend to drive a mentee or their family member Trusted Mentors will ask for a copy of your driver’s license and a certification of insurance.
*
Signature
*
Schedule your interview here:
The next step is to have a one-on-one interview with one of our Mentor match Managers. The time slots below are when our staff will be available for mentor interviews. Interviews assist with matching, reinforce information from training and provide a one on one opportunity to ask questions.
Schedule an interview time. If these times do not work, skip the question and call 317-985-5041 to schedule.
Which format do you prefer for the interview?
In person, if fully vaccinated
Phone
Face Time (iPhone)
Zoom visual meeting
Submit
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Interest in Program and Experience
To assist with matching, please answer as many questions as possible.
How did you hear about Trusted Mentors? (Check all that apply.)
*
Trusted Mentors website
Volunteer Match
United Way
Gala
Other Event
Friend (if so, please include the name below)
Other
Why do you want to mentor with Trusted Mentors?
*
Do you have any previous experience (personal, volunteer or work-related) in any of the following areas? If yes, please describe.
Homeless Prevention
Foster Care
Re-entry
Mental Illness
Homeless
Incarceration
Addictions
Description of experience:
In what specific area could you support a mentee?
Personal finance
Obtaining /retaining employment
Improving level of education
Improving homemaking skills
Establishing a network of reliable people
Childcare and parenting issues
Maintaining stable housing
Transitioning from recovery house
Transition from incarceration to the community
Transition from foster care to independent life
Completing the process of divorce
Help develop methods to prevent living in crisis
Are you interested in other areas of support for Trusted Mentors, such as:
Special Events
Financial Contributions
Mentor Recruitment
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Other Information
To assist with matching, please answer as many questions as possible.
What times are you available to mentor?
Weekdays AM
Weekend AM
Weekdays PM
Weekend PM
Other
Do you have transportation available?
Yes
No
At times, are you willing to drive your mentee?
Yes
No
Please upload a copy of your driver's license.
Browse Files
Front side only
Cancel
of
If yes, do you have insurance to cover another person in your car?
Yes
No
For liability purposes, please upload a copy of auto insurance.
Browse Files
Cancel
of
Are you interested in a faith-based match?
*
Yes
No
Either
Have you ever been convicted of a crime?
*
Yes
No
If yes, please explain conviction. You will have an opportunity to discuss further in the mentor interview.
Have you ever been investigated for child abuse or neglect?
*
Yes
No
If yes, please explain the investigation of child abuse or neglect. You will have an opportunity to discuss further in the mentor interview.
Some of the programs Trusted Mentors works with might require meeting with a mentee at their home. How comfortable would you be meeting with a mentee in their home?
1
2
3
4
5
Low
High
1 is Low, 5 is High
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Employment, Education and Volunteer Information
To assist with matching, please answer as many questions as possible.
Current Employer
(or enter 'Retired')
Title:
(If Retired, enter former title or profession.)
Length of Employment
# of Years
Does your current employer offer contribution matching?
Yes
No
Education Level Completed
*
8th Grade or Less
9th - 11th Grade
HS Diploma
GED / HSE
Some College
Associates Degree
Bachelors Degree
Masters Degree
Doctoral Degree
Education Description
Certificates, Licenses, Major, etc.
Past Volunteering:
Agency, Position, Start Date, End Date
Should be Empty: