* - Required field

Volunteer Considerations
I am applying to become a...
Mentor
Board Member (invitation only)
Both (Mentor and Board Member)
I will be able to meet my mentee once a week during the school year.
YesNo
I do not forsee any moves or job changes that would prevent me from mentoring the next 3 years.
YesNo
I will be able to mentor at school, during the school day.
YesNo
I have reliable transportation to a school for mentoring.
YesNo
I will attend an initial 2.5 hour, in person new mentor training.
YesNo
Personal Information
* First Name
* Last Name
Maiden or Other Legal Name
* Date of Birth
* In what CHAPTER would you like to mentor?
  
At what SCHOOL would you like to mentor? If you do not know please type unknown in the box and then select unknown and you will be contacted by TeamMates to discuss your local options
  
If School is unknown please type unknown in the box to the right
Preferred Mailing Type
* Home Address
* Home City
* Home State
Home Zip Code
Home Phone
Work Phone
Work Phone Extension
Cell Phone
* Email
Gender
Ethnic Indicator: Hispanic/ Latino
YesNo
Race
If Other Race:
Highest level of education completed
If other:
How did you hear about TeamMates?
Details on how you heard about TeamMatesName of Mentor, Business, etc.
If other
Do you speak a second language?
If yes, please specify which language
* Please select item(s) that best categorize your current status
Please specify other category of employment
* Current Place of Employment
Please specify if other here
* Occupation
* Student College or University
* Student Year in College
Family Reference
* First Name
* Last Name
Relationship
Cell Phone
* Home Phone
Work Phone
Email
Friend Reference (person that has known you for over a year and is not a family member)
* First Name
* Last Name
Relationship
Cell Phone
* Home Phone
Work Phone
Email
Employer/Other Reference (person that has known you for over a year and is not a family member)
* First Name
* Last Name
Relationship
Cell Phone
* Home Phone
Work Phone
Email
Emergency Contact Info
Emergency Contact Name
Emergency Contact Phone Number
Other Considerations
Do you have any future changes that will affect your ability to mentor, such as a job change, extended travel,military deployment, study abroad, internship participation, student teaching, etc?
YesNo
If yes, please details the change and the year this will happen
Do you have an specific training, skills, or hobbies that would be beneficial for your mentoring experience?
YesNo
If yes, please explain
Why are you interested in becoming a mentor?
What are you hoping to get out of this experience?
What do you hope your mentee will get out of this experience?
Have you previously applied to be a volunteer in other youth serving organizations?
YesNo
If yes, please explain