UWNEMN Lunch Buddies Mentor Application | United Way of Northeastern Minnesota

Thank you for your interest in becoming a Lunch Buddy mentor!

The Lunch Buddies mentoring program is currently suspended due to COVID-19. Stay tuned for information on the 2020-2021 school year.
If you'd like to submit an application for consideration for next year's program, please review the following information:

Before submitting the below application, please click here to review the mentor position description.

If you prefer to print and mail your application, click here to download the form.

As a reminder, an interview and background check are part of the application process.

Name

Date of Birth

Gender

Street Address (including city, state, zip code)

Home/Cell Phone

Work Phone

Indicate the preference for which school you would like to mentor at:

Do you understand the mentor program involves spending a minimum of 40 minutes/week for the academic year at a school with the assigned student?

Do you understand that mentoring programming will occur March 2nd to May 19th on Mondays (Greenhaven) and Tuesdays (Washington) for the remainder of the 2019-2020 school year?

Do you understand that you will be required to complete the mentor training session prior to participating in the program?

1. What motivates you to volunteer as a mentor?

2. Please describe any previous experience you have volunteering or working with youth.

3. What qualities, skills, or other attributes do you feel you have that would benefit a mentee? Please explain.

4. Please describe any health concerns you have that might impact your participation in this program.

5. How would you describe yourself?

6. How would your friends, family, and co-workers describe you?

7. Have you ever been arrested or convicted of a crime? If so, what were the circumstances?

8. Have you ever been investigated or convicted of sexually abusing or molesting a youth 18 or younger? If yes, please explain.

Are you willing to communicate regularly and openly with program staff, provide monthly information regarding your mentoring activities, and receive feedback regarding any difficulties during your participation in the mentoring program?

Education Background (check one)

Other:

Please provide employment information for the past five years, with most recent position held first.

Please list the names, addresses, and phone numbers of three people you would like to use as character references (only people you have known for at least a year).

Do you speak any languages other than English? If so, which languages?

If so, which languages?

What are some favorite things you like to do with other people?

What are your favorite subjects to read about?

What is your job and how did you choose this field?

What is one goal you have set for the future?

If you could learn something new, what would it be?

What person do you most admire and why?

Describe your ideal Saturday.

Please check all activities you are interested in:

List any other areas of strong interest:

I agree to follow all mentoring program guidelines and understand that any violation will result in suspension and/or termination of the mentoring relationship.

I understand that United Way of Northeastern Minnesota is not obligated to provide a reason for their decision in accepting or rejecting me as a mentor.

In making this application to be a volunteer, I understand that United Way of Northeastern Minnesota routinely performs criminal record checks of all volunteers for the position of mentor for which I am applying. This check may be done on me if I sign below. If I fail to sign, it may be grounds for rejecting me as a mentor.

(optional) I agree to allow United Way of Northeastern Minnesota to use any photographic image of me taken while participating in the mentoring program. These images may be used in promotions or other related marketing materials.

E-Signature

Date

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