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Volunteer Mentor Application
Apply to become a mentor!
Congratulations on taking the first step to becoming a mentor in the Jewish Youth Mentoring Program! We know you may have questions about what will be expected from you as a mentor. Being a mentor is not complicated or especially time consuming; however it does involve a consistent commitment that will result in a positive impact for youth in our community.
What does it take to be a mentor? Ask yourself if you can...
• Meet your mentee consistently, two to four times per month • Commit to being a mentor to your mentee for at least 12 months from match date. Studies show that youth achieve the greatest impacts when they have been matched for at least one year. • Dedicate the time with your mentee to just the two of you. Your undivided attention is essential in helping a youth reach their full potential. • Contact the Program Coordinator each month. The Program Coordinator will be there to guide your match relationship: to answer your questions, offer advice, help you and your mentee have a safe and fun relationship, and share match activity ideas. • Have reliable transportation and/or technology for meeting with your mentee.
Based upon the information above, do you feel this is the right time for you to be a mentor?
We hope your answer is "Yes!", but if you have questions, you will have the opportunity during your interview to speak with the Program Manager about your individual situation. Remember: being a mentor isn't about finding time for a mentee; it's about inviting a mentee into the life you are already living.
*Please note: Your responses to these questions will not impact your eligibility to be a mentor in our program. These answers help us to best match you with a mentee.
Name
*
First
Last
I prefer to be called
Date of Birth
*
MM slash DD slash YYYY
Gender Identified as
*
Email
*
Enter Email
Confirm Email
Primary phone
*
Type
*
Home
Cell
Work
Alternate Phone
Type
Home
Cell
Work
Ok to leave a message?
*
Yes
No
Would you like to receive text messages?
*
Yes
No
Address
*
Street Address
Address Line 2
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Best way to reach you
*
Call
Text
Email
Best time to reach you
*
AM
PM
Emergency Contact Name
*
First
Last
Relationship to Applicant
*
Emergency Contact Phone
*
Emergency Contact Email
*
Background
Education
Educational background, degrees, and/or special training
Are you currently employed?
*
Yes
No
Full or part time?
*
Full time
Part time
Current Employer
*
Industry or type of business
*
Current Job Title
*
Do you have any previous experience (formally or informally) working with or mentoring youth?
*
Yes
No
If YES, please provide a summary of your involvement.
*
Have you volunteered at JFCS before?
*
Yes
No
If yes, when and in what role?
*
Volunteer Profile
What motivates you to mentor a child now?
*
What value do you believe a mentor brings to the life of a young person?
*
What qualities, skills, or other attributes do you feel you have that would benefit a young person? Please explain.
*
Check all activities/ areas of interest:
*
Amusement Parks
Animals
Biking
Board Games
Bowling
Canoeing/Kayaking
Cars
Ceramics
Computers
Cooking/Baking
Crafts
Dance
Drawing
Eating
Fishing
Gardening
Golf
Hiking
Ice Skating
Knitting
LEGOs/Building Toys
Movies
Museums
Music
Painting
Photography
Reading
Rock Climbing
Running
Scrapbooking
Sculpting
Sewing
Singing
Skate Boarding
Skiing/Snowboarding
Sporting Events
STEM (Science, Technology, Engineering, and Math)
Swimming
Tennis
Theater
Video Games
Walking
Weightlifting
Woodworking
Writing
Other
If other, please specify
*
Volunteer Preferences
I think I could do well mentoring a child who is described as…
*
(check all that apply)
Adaptable
Adventurous
Affectionate
Assertive
Caring
Clever
Competitive
Confident
Creative
Distractible
Energetic
Forgiving
Friendly
Funny
Hardworking
Impulsive
Indecisive
Independent
Inquisitive
Insecure
Moody
Outgoing
Persistent
Quiet
Rebellious
Reluctant
Sensitive
Shy
Silly
Stubborn
Studious
Talkative
Timid
Some of the youth we serve have disabilities. Would you be comfortable mentoring a child with the following disabilities?
*
(Check all that apply)
Physical Disabilities (such as hearing loss, wheelchair use, etc.)
Developmental Disabilities (such as Autism Spectrum Disorder, cerebral palsy, etc.)
Mental health diagnoses (such as ADHD, anxiety, depression, etc.)
Learning Disabilities
Medical Conditions
Allergies (including food allergies)
None of the above
Pre-Interview Questions
Do you have any concerns about your ability to fulfill the 12- month commitment required of mentors?
*
Yes
No
If YES, please explain.
*
Have you had or do you anticipate having any significant life changes over the next year?
*
Yes
No
If YES, please explain.
*
Do you have any health factors (mental, physical, or emotional) that could impact your ability to engage with a mentee?
*
Yes
No
If YES, please explain.
*
Have you ever been accused, arrested, charged, or convicted of a crime?
*
Yes
No
If YES, please explain.
*
What is your availability to meet with your mentee?
*
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Driver information
Do you drive?
*
Yes
No
Make and Model of Car
*
Minnesota Drivers License Number
*
Auto Insurance Company Name
*
Auto Insurance Policy Number
*
Have you had any speeding tickets or other moving violations in the past 5 years?
*
Yes
No
If YES, please explain.
*
Have you been involved in any automobile accidents in the past 5 years?
*
Yes
No
If YES, please explain.
*
General Volunteer Information
How did you learn about our volunteer program?
*
Select all that apply.
Friend in the program
JFCS staff or board member
Synagogue or other bulletin
Flyer
Volunteer match
JFCS website
e-directions newsletter
Directions magazine
Jewish Minnesota website
Other
If other, please specify
*
References
Please provide contact information for 3 references. Please give complete information in order to process your application.
Personal Reference Name
First
Last
Relationship to applicant
Years known
Email
Phone
Professional Reference #1 Name
First
Last
Relationship to applicant
Years known
Email
Phone
Professional Reference #2 Name
First
Last
Relationship to applicant
Years known
Email
Phone
Consent
*
I agree to the following:
In making this application to be a volunteer, I understand that Jewish Family & Children’s Service of Minneapolis routinely performs criminal and driving record checks of all volunteers for the position of mentor for which I am applying.
I certify to the best of my ability that the information provided on this application is true and accurate.
Date
MM slash DD slash YYYY
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