MentorSports — Mentor Application

1Personal Information

Full Name *

Date of Birth *

Gender *

Male Female Prefer not to say

Street Address *

City, State, ZIP *

Mobile Phone *

Home Phone

Email *

Employer

Occupation

Employer Address

Work Phone

2Mentor Interest & Availability

Which age groups would you like to mentor? *

Youth (5–10) Pre-Teen (11–13) Teen (14–18)

Which areas can you mentor or coach in? *

What strengths do you bring to this program? * For example: playing or coaching experience, bilingual, patience with kids, prior mentoring or volunteer work.

Why do you want to be a MentorSports mentor? *

What times work best? *

Mornings Afternoons Evenings Weekends

I understand the mentor role asks for a minimum of one hour each week throughout the season with an assigned athlete. *

Yes No

I understand I must complete mentor orientation and at least two training sessions during the year. *

Yes No

3Experience & Education

Highest level of education *

Athletic or coaching background Teams or sports you've played, levels coached, any coaching or officiating certifications.

Previous mentoring or volunteer experience

Do you currently hold CPR / First Aid certification?

Yes No Expired

4Safety Screening

MentorSports works with children. The safety of our athletes comes first, so every prospective mentor completes a screening and background check before being matched with a youth.

Within the last 10 years, have you been convicted of a felony or misdemeanor classified as an offense against a person or family, an offense of public indecency, or a violation involving a controlled substance? *

Yes No

Are you under current indictment, or has a district/county attorney accepted a complaint for any of these offenses? *

Yes No

If you answered Yes to either question above, please explain

[MentorSports: insert your background-check provider, any cost, and where applicants submit results. The other organization's payment and mailing instructions were removed — replace this with your own process.]

Background check authorization * I authorize MentorSports to conduct a criminal and driving-record background check as part of this application.

5References

Please list four references, including at least one family member, one personal friend, and one work reference. The first two are required.

6Certification & Code of Conduct

Certification * I certify, to the best of my ability, that the information on this application is true and accurate. I understand that knowingly providing false information is grounds for dismissal.

Code of Conduct * I have read and agree to abide by the MentorSports Code of Conduct.

Signature (type your full legal name) *

Date *

Your security: Do not enter your Social Security Number on this form. SSN and other sensitive details needed for record checks are collected separately and securely during the official background-check step.

7Get To Know YouOptional

Do you prefer working with a particular age level?

Do you prefer working with a

Do you prefer a quiet, reserved athlete?

Do you prefer an outgoing athlete?

Hobbies or interests

What would you like to do with a mentee?

Your favorite sport growing up

Do you speak another language? Which?

Who has been a role model for you, and why?

One book you'd recommend to your mentee

Mentor Application

Review & submit your application

You're on the waitlist!