LA Cares Mentoring Recruitment Form

Facts for Potential Mentors

Webster Dictionary defines a mentor as: A wise Advisor, Teacher or Coach

The Los Angeles CARES

Mentoring Movement currently works with 10 mentoring organizations. Some of our partner organizations only provide opportunities tovolunteerrather than direct mentoring.

The Village Nation www.TheVillagenation.com and Runway 4 Peace www.runway4peace.com offer volunteer opportunities through their organizations. Please visit their respective websites to see how you can become more involved.

You may also complete this form below and submit it. One of our representatives will follow up with you shortly to inquire more about your desire to become a mentor or volunteer.

The information collected will be used solely for the purpose of Mentor/Mentee matching and will only be shared with our vetted community based organizations we have partnership agreements with for this purpose.

Name

PrefixFirst NameMiddle NameLast NameSuffix

Gender

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

E-mail

Have you ever mentored before?

Other

Do you have any teaching experience/

Was a background screening completed?

What age group would prefer to mentor

Why do you feel you would be a good mentor?

Did you ever have a mentor?

How did your mentor work for you?

What is your current or past profession?

Which would you prefer to mentor?

Number of hours you can commit per week?

Other

Number of hours you can commit per month?

Other

Are you available to attend our mentor orientation training?

Who provided you with this application?

Date

MonthDayYear

Signature