Mentor Application Name * First Name Last Name Email * Phone * (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country How did you hear about The N° Project? * Do you attend Neighborhood Church? * Yes No We will try to match students with mentors that share their college/career interests: Please list any colleges or trade schools you attended. * Please list any degrees or certificates that you have. * Please list any jobs you have had. * Why are you interested in becoming a Mentor? * Do you have any previous experience working with teenagers? If so, please list your experiences.. * Have you been convicted of a felony in the last 7 years? * Yes No Have you ever been convicted of a criminal offense that would include the sale or use of drugs, child abuse, or a crime involving actual or attempted sexual molestation of a minor? * Yes No If YES on (a) or (b) please explain. Are you willing to undergo a background check and give consent to being fingerprinted? * Yes No Electronic Signature * Please type your full name. Date * MM DD YYYY Thank you for your application! We will be in touch soon.
