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Sierra Vista Child & Family Services Mentor Application


Mentor Information
This question requires a valid email address.
Gender *This question is required.
This question requires a valid date format of MM/DD/YYYY.
Education *This question is required.
Space Cell School AttendedMajor Area(s) Of StudyDegree
School 1:
School 2:
How were you recruited as a Mentor? (Mark only one) *This question is required.
Personal Data:

Are you currently awaiting trial for any criminal offenses?

*This question is required.

Have you or any members of your immediate family received services from Sierra Vista Child & Family Services during the past 2 years?

*This question is required.
If your answer is yes, you may not be eligible to volunteer.
Please check and list any special interests, talents or skills that you would like to share: *This question is required.
Employment History: *This question is required.
This question requires a valid date format of MM/DD/YYYY.
Describe past employment/position(s) held:
Space Cell EmployerJob TitleDates of EmploymentSupervisorContact Phone
Personal Qualities:
List three things that may be important to know about you: *This question is required.
Each school has a mentoring program Site Supervisor that is your contact person for our program. They will provide you with important information on your mentee as well as scheduling.

What is the best way to contact you? *This question is required.
Check Availability: *This question is required.
Space Cell 9:00 AM10:00 AM11:00 AM12:00 PM1:00 PM
Emergency Contacts: Please list two people to notify in case of an accident or emergency:
Emergency Contact 1: *This question is required.
Emergency Contact 2: *This question is required.
References: List three people who may be contacted for a personal/professional reference:
Reference 1: *This question is required.
Reference 2: *This question is required.
Reference 3:

I hereby certify I have not knowingly withheld any information that might adversely affect my chances for volunteering and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand any omission or misstatement of material fact on this application or on any document used to secure a volunteer position shall be grounds for rejection of this application or for immediate discharge if I am volunteering, regardless of the time elapsed before discovery.

*This question is required.
Signature of
I hereby authorize SVCFS to thoroughly investigate my references, work record, education and other matters related to my suitability for volunteering. I further authorize the references I have listed to disclose to the organization any and all letters, reports, and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release SVCFS, my former employers, and all other persons, corporations, partnerships, and associations from any and all claims, demands, or liabilities arising out of, or in any way related to, such investigation or disclosure. *This question is required.
Signature of
I understand nothing contained in this application or conveyed during any conversation or interview is intended to create an employment contract between me and the organization. In addition, I understand and agree if I become a volunteer, my position will not be for any specified period of time and may be terminated at any time, with or without prior notice, at the option of either myself or the organization. No promises or representations contrary to the foregoing are binding on the organization unless made in writing and signed by the Executive Director of SVCFS. The fact that I may complete a specified probationary period will not change this. The Executive Director reserves the right to refuse any applicant participation. *This question is required.
Signature of
Signature of Applicant: *This question is required.
Signature of
This question requires a valid date format of MM/DD/YYYY.