Stoked Mentoring

Mentor Application

 

City: 

 

Birthdate:

Gender:

 

Secondary Email:

Other Phone:

Preferred Method of Communication:

 

Facebook:

Myspace:

Occupation:

Occupational Field:

 

Supervisor Name:

Supervisor Phone:

Supervisor Email:

Factors for Mentor Motivation:

 

Goal Comments:

Skateboarding:

 

Surfing:

 

Snowboarding:

 

Action Sports Comments:

Playing Sports Detail:

 

Watching Sports Detail:

 

Cultural Events Detail:

 

Interest Comments:

Education Level:

 

School Name:

Degree Year:

Shirt Size:

 

Jacket Size:

 

Pant Size:

 

Shoe Size:

 

Recruitment Source:

 

I have read the information pertaining to becoming a mentor and agree that I meet all of the listed requirements. I fully understand that submitting an application does not guarantee me an interview/or a place in the program. I understand that if selected, I will be matched with a youth and have the possibility of being matched for a program season. Should I be unable to participate in the program I have been matched for, I will forfeit my spot on the matching list and be placed at the bottom to be matched at a later date. I understand that I will be interviewed, have references checked and fingerprinted before should I be accepted into the program. I understand that I will also be required to attend trainings designed to prepare me for mentoring a youth and failure to attend trainings automatically disqualifies me from the program. In the event that Stoked deems you ineligible to participate in the program, by singing below you understand that the specific reason will not be provided.

Stoked Mentoring does not discriminate with regard to an applicant’s race, color, creed, gender, sexual orientation, marital status, place of natural origin, age or disability.