Mentorship Application - Step 1

Student Preferences:

Number of students to mentor:*

Gender:

No Preference

Girl

Boy

Tribal Affiliation:

School Level:

Your Contact Information

We ask that mentors commit to a minimum of two years

Full Name:*

Address:*

City:*

State/Country:*

Zip:*

Home Phone:*

Work Phone:

Cell Phone:

Email Address:*

Fax:

Tell us about yourself

Your Career/Employer:

Check to see if your employer has a matching gift program and let us know!

Spouse/Partner Name:

Spouse/Partner career/employer:

Child(ren) name(s)/age(s):

Where were you born and raised?

Hobbies/interests:

Why do you want to be a mentor?

How did you hear about Futures for Children?

New Mentor Agreement

I/We are committed to being a Futures for Children mentor and in developing a cross-cultural friendship. I/We will write to my/our mentored student(s) at least every other month. I/We value education and will strongly encourage my/our mentored student(s) to complete high school and pursue post-secondary opportunities. I/We commit to a minimum of two years of mentorship. I/We understand that to ensure the safety of the students, background checks are required.

Mentor(s) Initials: *