Kids Hope Mentor Application

Thank you for your interest in mentoring with our church and Kids Hope USA. Please read and complete the following information in order to be considered for this important role in our mentoring program. A Kids hope USA mentor will provide one-to-one mentoring and affirmation for one elementary-aged child at Edison Elementary School. Training will be provided to help mentors develop a successful mentoring relationship with a child. The mentor will use materials provided by their Kids Hope USA program. The classroom teacher may supplement with materials to support a specific academic need. Each Kids Hope USA mentor will be under the supervision of and report to the Kids Hope USA director (Brandon Anderson) who will be available to advice and assist all mentors.

Qualifications:

1. Love children and be sensitive to their nees
2. Maintain confidentiality
3. Be ready to listen to a child
4. Pass a background check
5. Commit to one hour each week during the school day for a school year
6. Be a memeber or regular attendee of Cragmor
7. Believe in your child
8. Be at least 16 years old
9. Be able to read
10. Reliable transportation

Name

Address

Phone

This address will receive a confirmation email

Have you ever been convicted of, pled guilty to, or pled no contest to a crime other than a minor traffic violation?

Yes No

If yes, please explain:

Please indicate the days you are available:

Monday Tuesday Wednesday Thursday Friday

Please indicate the times that you are available on those days:

Please list previous volunteer activities:

References:

List at lease two references from places of employment or prior volunteer service, specifically work with youth and children. References must be over the age of 18; not be a relative; have known you for at least a year.

Reference 1 Name:

Reference 1 Address:

Reference 1 Phone #:

Reference 1 Email

Reference 1 Relationship:

Reference 1 Length of relationship:

Reference 2 Name:

Reference 2 Address:

Reference 2 Phone #:

Reference 2 Email

Reference 2 Relationship:

Reference 2 Length of relationship:

Reference 3 Name:

Reference 3 Address:

Reference 3 Phone #:

Reference 3 Email

Reference 3 Relationship:

Reference 3 Length of relationship:

Prayer Partners

Do you have someone in mind to be your Prayer Partner?

Yes No

If yes, please list their Name and Email`

Description

Thank you for your interest in impacting the life of a student in our community. Please fill out this form so that we can place you with the right student ASAP.

Kids Hope Mentor Application

Description

Please Fix the Following