BEST Kids Mentor Application

BEST Kids Volunteer Mentor Application

Thank you for taking the time to fill out the application to become a BEST Kids mentor!
If you have any questions, comments, and/or concerns regarding the online application, please call BEST Kids' Recruitment and Admissions Coordinator, Keesha Lockette, at 724-833-3720. Thank you and we look forward to reviewing your application!

Basic Information *This question is required.

First Name

Last Name

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

calendar

Primary Phone Number

Secondary Phone Number

Street Address

Apt/Suite/Office

City

If other is selected, please name the state you reside in abbreviated form

Zip

Email Address This question requires a valid email address.

Confirm Email Address

Have you resided in any other state in the last 5 years? *This question is required.

Please list all states that you have resided in within the last 5 years

Have you ever been known by a different name?

If so, what name(s)?

Languages spoken