Mentor Questionnaire

* Indicates required field

Name *

First

Last

Education (Include College Attended) *

Other Education *

Have you ever worked with young people before? *

Current Position *

Have you ever mentored before? *

If so, please describe: *

What job skills can you share with a mentee? *

What hobbies can you share with a mentee? *

Other than hobbies listed above, what do you like to do in your free time? *

Do you anticipate any changes in the next year that may interfere with your ability to meet your commitment as a mentor such as marriage, childbirth, new job, moving? If yes, please explain: *

Please provide any additional information that you feel would help us match you with a youth (e.g., favor college and professional sport teams): *

Can you commit to spending a minimum of 2-3 hours per month for one year with a student? *

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Mentor Questionnaire

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