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Mentor Application



Please stop the application process and launch this application form using the invitation in the email you received. If you require a link, please contact  Lauren Ayers, Director of Mentor Development at lauren@ymionline.org

This will ensure a seamless process and prevent delays with your application.

Thank you!
Personal and Contact Information
This question requires a valid email address.
Gender *This question is required.
This question requires a valid date format of MM/DD/YYYY.
calendar
Race/Ethnic Identification: We attempt to match our students and mentors with as many commonalities as possible. This information is not required but can be extremely helpful especially as students request or need a mentor sharing their race/ethnic identification.
 What social media platforms do you utilize (check all that apply) *This question is required.
Marital Status: *This question is required.
Partner Information:
Emergency Contact (If different from the person listed above):
Education Information *This question is required.
Highest Level of Education *This question is required.
Employment Status *This question is required.
Employment Information
Employer/Supervisor: (Your supervisor may be contacted as a reference.)
This question requires a valid email address.
T-Shirt size *This question is required.
Do you have any previous experience (formally or informally) mentoring youth? *This question is required.
Do you have any experience and/or training to be equipped to mentor students? (check all that apply): *This question is required.
Do you speak any language other than English? *This question is required.
If yes, which language(s)?
Have you ever been arrested or convicted of a crime? *This question is required.
Have you ever been convicted of a DUI or DWI? *This question is required.
Have you ever been convicted of child abuse or neglect? *This question is required.
Have you ever been investigated and/or convicted of sexually abuse or molestation? *This question is required.
How did you hear about YMI?
Referral Type *This question is required.
Please enter the specific Publication/Location/Person/Event related to the Referral Type question above:
Are you a member of a local church or place of worship?
Please answer the following questions as thoroughly as possible:
Our philosophy at YMI is, “Share YOUR Life to Change a Life” and we truly believe that our unique life experiences, both the good and the bad, are a significant part of the mentoring role. You can assist us in the matching process by checking any of the Life Experience labels that you feel you are especially equipped for:
Life and Situations Experienced *This question is required.
Check next to any of the words below that you think describe your personality. *This question is required.
Check all topics and activities that interest you. *This question is required.Please check a minimum of 5.
Please provide 1 professional reference and 2 character references.  At least one reference has to have known you for longer than 3 years. These individuals may be contacted by phone or email by YMI staff.  
Professional Reference
This question requires a valid email address.
Character Reference
This question requires a valid email address.
Character Reference
This question requires a valid email address.