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Successful Families

Volunteer Application for Mentorship Opportunity

Successful Families mentoring programs are one-to-one peer support program for mothers and youth dealing with the life challenges. The programs are strength based, recognizing that every individual has positives to build upon. Throughout the 12-18 month mentoring relationship, our mentors provide a trusted, informal healthy support network to help our mentees achieve personal growth and gain a sense self-efficacy.

This opportunity requires a 2-4 hour commitment 1-2 times per month for the duration of the mentoring match.

Please specify which program you are applying for. (Note: Mentoring Moms accepts female volunteers only) *This question is required.

Personal Information

First Name *This question is required.

Last Name *This question is required.

Street Address *This question is required.

Apt/Suite/Office

City *This question is required.

State *This question is required.

Zip *This question is required.

Email Address *This question is required. This question requires a valid email address.

Home Phone

Mobile Phone

Best Daytime Phone *This question is required.

Gender *This question is required.

Date of Birth (MM/DD/YYYY) *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

Ethnicity

Employment

Occupation
Employer
Business Telephone

Highest Level of Education *This question is required.

Briefly describe previous relevant volunteer experience *This question is required.

Have you ever been accused, arrested or convicted of a crime? Responding yes does not necessarily disqualify you from participating in a mentoring program. *This question is required.

Briefly explain your answer to the previous question.

Are you currently on probation? Responding yes does not necessarily disqualify you from participating in a mentoring program. *This question is required.

Briefly explain your answer to the previous question specifying the probation period.

Have you or anyone in your household had an open case with Division of Child Protection and Permanency within the past 5 years? Responding yes does not necessarily disqualify you from participating in a mentoring program. *This question is required.

Briefly explain your answer to the previous question.

Do you have a valid NJ Driver's License? *This question is required.

Briefly describe what attracted you to this volunteer opportunity.

I hereby certify that the information above is true and correct to the best of my knowledge. I understand that a false statement could disqualify my application. *This question is required.

Clear

Signature of

Following a review of your application, a member of our team will contact you for an intake interview. Following a successful interview, you will be subject to an extensive background check prior to being invited to our next volunteer training session. You may direct questions to Phillicia DaCosta pdacosta@bergenvolunteers.org for Mentoring Moms or Yamilet Torres ytorres@bergenvolunteers.org for Mentoring Youth. The number for the Bergen Volunteer Center is (201) 489-9454.