S.T.Y.L.E. Mentor Application Question Title * 1. Personal Information Name Address Address 2 City/Town State/Province -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code Email Address Cell Phone Number Question Title * 2. Alternative Phone Number Question Title * 3. Date of Birth Question Title * 4. Please list all members of your household over the age of 18. Name Sex (F/M) Age Relationship to Applicant Question Title * 5. Please list all members of your household over the age of 18. Name Sex (F/M) Age Relationship to Applicant Question Title * 6. Please list all members of your household over the age of 18. Name Sex (F/M) Age Relationship to Applicant Question Title * 7. Please list all members of your household over the age of 18. Name Sex (F/M) Age Relationship to Applicant Question Title * 8. Employment History: Please provide employment information for the past five years, with the most recent position held first. If more space is needed, please email separately to info@stylementoring.org. Employer Street Address City Zip Code Supervisor's Name Title Phone Number Question Title * 9. Employment History: Please provide employment information for the past five years, with the most recent position held first. If more space is needed, please email separately to info@stylementoring.org. Employer Street Address City Zip Code Supervisor's Name Title Phone Number Question Title * 10. Employment History: Please provide employment information for the past five years, with the most recent position held first. If more space is needed, please email separately to info@stylementoring.org. Employer Street Address City Zip Code Supervisor's Name Title Phone Number Question Title * 11. Application QuestionsPlease answer all of the following questions as completely as possible. Why do you want to become a mentor? Question Title * 12. Do you have any previous experience volunteering or working with youth? If so, please specify. Question Title * 13. What qualities, skills, or other attributes do you feel you have that would benefit a youth? Please explain. Question Title * 14. Can you commit to participating in the S.T.Y.L.E. Mentoring Program for a minimum of one year from the time that you are matched with a mentee with the possibility through high school graduation? Yes No Question Title * 15. Are you available to meet with a mentee eight hours per month and have contact at least once per week? Please explain any particular scheduling issues. Question Title * 16. How would you describe your personality? Question Title * 17. How would your friends, family, and co-workers describe you? Question Title * 18. 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? Yes No Question Title * 19. S.T.Y.L.E. Mentoring Program appreciates your interest in becoming a mentor. Please initial each of the following. 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 S.T.Y.L.E. Mentoring Program is not obligated to provide a reason for their decision in accepting or rejecting me as a mentor. (Optional) I agree to allow S.T.Y.L.E. Mentoring Program 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. I agree to attend the initial mentor training session and in-service training session per year after being matched. Question Title * 20. I understand I must return all of the following completed items along with this application, and that any incomplete information will result in the delay of my application being processed.- Copy of your valid driver's license - Information Release Form (I-CHAT)- Interest Survey Form Done