Tool 1: Sample application for potential members
Mentor Application
Name
Address
Phone #:
Date of birth:
Work history (starting with most recent):
Company Position held Dates Primary Responsibilities
1.
2.
3.
Educational Background:
- Did you attend college?
- For how long?
- Name of university or college?
- Have you had any post-secondary training?
- If so where?
- How long?
- Kind of training?
Why are you interested in becoming a volunteer mentor?
What kinds of experiences have you had working with adolescents?
What kinds of skills and special abilities can you bring to our program that might be useful for adolescents to acquire?
Tool 2: Sample reference form
Reference form
Name of applicant:
Your name:
Your title and place of employment:
How long have you known the applicant?
In what capacity have you known the applicant (teacher, supervisor, friend, co-worker)?
Please describe the applicant in terms of personal values and life stability:
Please comment on the applicant's ability to function as a mentor/role model for adolescents, ages 12 to 17, including knowledge you have of applicant's experiences with children.
Briefly describe a situation in which you have witnessed the applicant engaging in one of the following activities:
- Teaching someone a skill
- Instructing someone in a complicated process
- Providing personal counseling
- Organizing projects and assigning tasks
Tool 3: Sample skills inventory
| Maintenance __Window washing __Floor waxing / mopping __General household cleaning __Lawn care / landscaping __Floor stripping / sanding __Wood stripping / refinishing __House painting - outside __House painting - inside __Plumbing __Electrical |
Computers __Word processor __Database program __Statistical program __Graphics program __Computer programming |
| Construction __Installing drywall __Building demolition __Building houses __Room remodeling __Bathroom remodeling __Bricklaying / masonry __Cement mixing / pouring __Installing insulation __Furniture / cabinet making __Carpentry skills __Roofing |
Food __Catering __Short-order cook __Bartending __Baking __Line cook __Head chef |
| Health __First Aid __Nursing __Dental Care __Caring for people with severe disabilities __Caring for people with mental illness |
Education / Child Care __Parenting __Elementary school teaching __Middle school teaching __High school teaching __Early childhood education __Daycare __Babysitting __Camp instructor __Lifeguard |
| Office __Typing __Copy machine __Fax machine __Multiple-line phone system __Filing __Bookkeeping |
Other __Hotel management __Hairstyling __Artist __Musician __Farmer __Security __Horticulture __Transportation / driver __Waiting tables __Product sales __Retail __Fashion design |
Tool 4: Sample values questions
-
What do you hope to gain by becoming a volunteer mentor?
-
What kind of experience have you had talking with your family members, friends, and co-workers about their difficulties?
-
How do you feel about how your life has been going lately? How satisfied are you right now?
-
Do you feel comfortable interacting with others one-on-one?
-
Are you able to work with persons who come from backgrounds very different from yours or whose lifestyles you don't agree with?
-
Are you able to be assertive?
-
How about with your ability to not give advice, even when you disagree with someone's decision?
Tool 5: Sample short answer questions
-
Why do you want to be a volunteer mentor?
-
What are the major responsibilities in your life right now?
-
What are your major interests?
-
What are your future plans and dreams?
-
How do you feel about the way your life is right now?
-
What words would you use to describe yourself?
-
What words would your friends/family/supervisor use to describe you?
-
What kinds of life changes have you experienced, including losses, relationship changes, family and friendship changes, or health, education, or self-awareness changes?
-
Who has been a role model or mentor to you in your life? How?
-
What kinds of influences do you think are good for children nowadays? Why?
-
What kinds of influences are bad for children nowadays? Why?
-
Who or what do you think is the most important influence in children's lives?