Application

Address *

Have you ever been accused, arrested convicted or pardoned of a sexual offence involving a child or children? *

Yes

No

3. Professional Reference (Current/former employer or other known professional) *

Name: *

2. Community/Service Reference (Community involvement or vulnerable sector) *

Phone *

Choose *

Male

Female

2. Home Phone *

Why do you want to become a Mentor in our program? *

Have you ever been convicted of a criminal offence? *

Yes

No

If you answered yes to either of the above questions, please specify:

.

How long have you lived in the area? *

When would you typically be available for an interview? Check all that apply: *

Weekday mornings

Weekday noon-hour

Weekday afternoons

Weekday evenings

Weekend

3. In what capacity? *

I understand that in submitting an application to become a mentor with Bruce Grey Mentorship, I am expressing my interest in being a positive role model for children and youth in the community, and that in committing I will be subject to various policies and procedures, regulations and expectations as set out by BGM for the safety and protection of its clients. I am committing to submit to the interview and screening process, and if selected, to attend all mandatory training as directed. Further I am confirming that to my knowledge, there is no reason or concern that would exclude me from working with or mentoring children and youth. I understand that Bruce Grey Mentorship, following review of my application, reserves the right to accept or refuse my application and is under no obligation to provide a reason. *

Yes

No

3. Home Phone *

What makes you a great candidate for a Mentor with Bruce Grey Mentorship? *

If employed, please choose

Full time

Part time

What values do you want to share with our mentees? *

Choose your areas of interest. Check all that apply:

1 on 1 Mentoring

Group Mentoring

Teen programs

Children's programs

leading a new/existing group

1. Business Phone

Will you submit to a Police Records check? *

Yes

No

Please confirm *

I am over the age of 18

I am under 18 and would like to be a Peer Mentor

Email: *

Check here to receive email updates

2. Business Phone

1. Personal/Character Reference (Must have know the applicant for at least 2 years): *

Your Name *

1. In what capacity? *

3. Business Phone

Why is mentoring important for children and youth in our community? *

2. How long have you known this person? *

2 years

3 to 5 years

5 to 10 years

10+ years

1. How long have you known this person? *

2 years

3 to 5 years

5 to 10 years

10+ years

1. Home Phone *

Date and time

If yes, please specify:

Living Situation *

Personal residence

Shared residence

no fixed address

parent/relative home

2. In what capacity? *

3. How long have you known this person? *

2 years

3 to 5 years

5 to 10 years

10+ years

Program Availability *

Weekdays

Weeknights

Weekends

Anytime

Relationship status *

Single

married/common law

Have you ever been, or applied to be a volunteer with a mentoring program in the past? *

Yes

No

Online Mentor Application