Student Leader Cohort MENTOR Interest Form

Thank you for your interest in serving as a volunteer for the new Student Leader Cohort.

It is a leadership-development experience that trains, equips, inspires and walks alongside high schoolers within the Baltimore-Washington Conference to grow in leadership and world-transforming discipleship. Read more about the cohort here.

The time commitment to serve as a mentor is a minimum of 8 hours per month. Mentors will be expected to conduct virtual/face-to-face meetings with youth and attend gathers of the entire Cohort.

Upon receipt of your interest form, you will be contacted regarding the next steps and to confirm your commitment.

Thank you again for your interest in the SLC and we look forward to growing with you!

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* 1. Your Contact Information

Name *

Home Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Email Address *

Mobile Phone Number *

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* 2. We value diversity in all its dimensions. Please share the following about yourself as you are able.

Gender (also for rooming purposes):

Race/Ethnicity:

Size of Your Church's Youth Group:

Context (rural, suburban, urban, etc.)

Position You Serve In Your Church's Youth Group:

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* 3. Please provide the following information

Home Church:

District:

Church Address:

Pastor's Name:

Pastor's Phone:

Pastor's Email:

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* 4. Which focus area are you interested in serving as a MENTOR:

BWC Annual Conference Sessions

Compassionate Justice

Mental Health

Project at Your Local Church or District

YPM Communications

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* 5. Are there other areas that you would be willing to serve as a volunteer?

	No	Maybe	Yes
Student Leader Cohort Orientation Retreat (annually in September)	Student Leader Cohort Orientation Retreat (annually in September) No	Student Leader Cohort Orientation Retreat (annually in September) Maybe	Student Leader Cohort Orientation Retreat (annually in September) Yes
Connect Leadership Summit (Student Leader Track) *formerly Leadership Days	Connect Leadership Summit (Student Leader Track) *formerly Leadership Days No	Connect Leadership Summit (Student Leader Track) *formerly Leadership Days Maybe	Connect Leadership Summit (Student Leader Track) *formerly Leadership Days Yes
BWC Annual Conference Session	BWC Annual Conference Session No	BWC Annual Conference Session Maybe	BWC Annual Conference Session Yes
Regional Breakouts at ROCK Retreat	Regional Breakouts at ROCK Retreat No	Regional Breakouts at ROCK Retreat Maybe	Regional Breakouts at ROCK Retreat Yes
District related events	District related events No	District related events Maybe	District related events Yes

Student Leader Cohort **MENTOR** Interest Form

Question Title

* 1. Your Contact Information

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* 2. We value diversity in all its dimensions. Please share the following about yourself as you are able.

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* 3. Please provide the following information

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* 4. Which focus area are you interested in serving as a MENTOR:

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* 5. Are there other areas that you would be willing to serve as a volunteer?

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* 6. How many hours a month will you be able to commit to the Cohort?

Student Leader Cohort MENTOR Interest Form