Mentor Matching Form

Name (required)

Address (required)

Email (required)

Phone Number(required)

Preferred form of contact: (required)

1. Why would you like to be a mentor?(required)

2. Briefly describe any experience you’ve had working with young people in either a professional or volunteer capacity?(required)

3. What skills do you feel you can bring to a mentee?(required)

4. What is your educational background?(required)

5. While in college, in what extracurricular activities were you involved?(required)

6. What are your personal goals?(required)

7. What do you feel are your strengths?(required)

8. What do you feel are your limitations?(required)

9. What hobbies do you have?(required)

10. What Qualities are you looking for in a mentee?(required)

11. What qualities would you find more difficult to work with?(required)

12. Do you have any preferences regarding the student you wish to be matched with?(required)

If Yes

Etnicity

13. Please list any concerns or areas of specific question you have about being a mentor.(required)

14. Is there any other information you would like to share that might help in the matching process?(required)

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