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Application Form For Mentor
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Your full legal name
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Email
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Phone Number
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Your current residential address
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What is your ethnicity?
*
African
European
Black American
White American
Asian
Latin American
Prefer not to state
What is your gender?
*
Male
Female
Prefer not to say
Other
other
*
What is your level of proficiency in English
*
Proficient (you have advanced knowledge of English)
Fluent (you can speak and write fairly well and can express any idea without hesitation)
Conversational (you can communicate on everyday topics)
Basiс (you know some phrases in this language)
List any other languages you speak and your level of proficiency in each.
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What is the highest degree or level of schooling you have completed?
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High School Diploma
Associate Degree
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other
Please list all the schools you attended. This helps us with the matching process
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Who is your current or most recent employer (enter your school if you are a graduate student)
What is your current or most recent job title?
Please list your areas of expertise (e.g. Computer Science, Electrical Engineering, Law, Economics, History, etc.)
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Describe your approach to mentoring
Describe the top 3 things or attributes you expect from your mentee
Describe any prior mentoring experience you may have, either as a mentor or mentee, and other relevant volunteer experience or involvement with young adults.
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Name of first reference
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Email address
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Mobile phone
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What's your relationship with this reference?
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Name of second reference
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Email address
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Mobile phone
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What's your relationship with this reference?
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How did you hear about VarsityMentor volunteer opportunity?
Someone referred me to the VarsityMentor Program
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Email listing
Other
other
Do you know anyone else (e.g. in your personal network or place of work) that you think would be a great mentor?
Please provide their name and email address
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Background Information
Your First Name
*
Your Last Name
*
Email Address
*
Mobile Phone
Please provide your LinkedIn Profile page
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What is your gender?
*
Male
Female
Prefer not to say
Other
gender
Please list any languages you are conversationally fluent in other than English
This will help us in matching mentors with students who speak other languages, e.g. Swahili, French, German, Spanish or Portuguese
Education and Career History
What is the highest degree or level of schooling you have completed?
*
High School Diploma
Associate Degree
Bachelors Degree
Masters Degree
Doctoral Degree (PhD)
Other
degree level
What is your current or most recent job title?
*
Who is your current or most recent employer?
*
Please, enter the name of your school if you are a graduate student
What is your discipline?
What makes you a good mentor?
*
Reference
Please provide the contact information of one person who can provide a professional reference in support of your application.
Name of referee
Referee's email address
Referee's phone number
What's your relationship with the referee?
Submit
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