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Add some fun to your week.

Become a Mentor.

Mentor Application

As a mentor, you’ll be welcomed onto a team of individuals from around your community who want to make a difference in a child’s life just as much as you do. You’ll receive training and instruction before you ever even meet your mentee so you’re sure to feel capable, competent, and confident when you start. Once you submit this application we will reach out to you promptly with next steps!

Name

First Name

Last Name

Phone

(###)

###

####

Gender

Date of Birth

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

SSN (must have for background check)

Race/Ethnicity

What interests you about becoming a mentor? Why are you drawn to this opportunity?

What do you hope to gain from this program as a mentor?

What are some of your personal hobbies/interests that might help you connect with a mentee that shares similar interests?

Do you have any reservations or concerns about being a mentor?

T-Shirt Sizes

Please indicate which day(s) you are available to mentor afterschool.

You will only serve one day a week.

I am able to work with an elementary student on Tuesdays from 3:00PM to 5:00PM.

I am able to work with a middle school student on Wednesdays from 3:00PM to 5:00PM.

Signature (Type Your Name)

By signing here, you authorize and consent to Uplift Mentoring using any of the above information to conduct a criminal background check.

Not ready to commit as a mentor just yet? No problem! Fill out this connect form and we will reach out to give you more information about what is looks like to become an Uplift Mentor!

Mentor Form