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Tool 1: Sample application for potential members

Mentor Application



Phone #:

Date of birth:

Work history (starting with most recent):

         Company                    Position held                    Dates                    Primary Responsibilities




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

__Window washing
__Floor waxing / mopping
__General household cleaning
__Lawn care / landscaping
__Floor stripping / sanding
__Wood stripping / refinishing
__House painting - outside
__House painting - inside
__Word processor
__Database program
__Statistical program
__Graphics program
__Computer programming
__Installing drywall
__Building demolition
__Building houses
__Room remodeling
__Bathroom remodeling
__Bricklaying / masonry
__Cement mixing  / pouring
__Installing insulation
__Furniture / cabinet making
__Carpentry skills
__Short-order cook
__Line cook
__Head chef
__First Aid
__Dental Care
__Caring for people with severe disabilities
__Caring for people with mental illness
Education / Child Care
__Elementary school teaching
__Middle school teaching
__High school  teaching
__Early childhood education
__Camp instructor
__Copy machine
__Fax machine
__Multiple-line phone system
__Hotel management
__Transportation / driver
__Waiting tables
__Product sales
__Fashion design

 Tool 4: Sample values questions

  1. What do you hope to gain by becoming a volunteer mentor?

  2. What kind of experience have you had talking with your family members, friends, and co-workers about their difficulties?

  3. How do you feel about how your life has been going lately? How satisfied are you right now?

  4. Do you feel comfortable interacting with others one-on-one?

  5. Are you able to work with persons who come from backgrounds very different from yours or whose lifestyles you don't agree with?

  6. Are you able to be assertive?

  7. How about with your ability to not give advice, even when you disagree with someone's decision?

Tool 5: Sample short answer questions

  1. Why do you want to be a volunteer mentor?

  2. What are the major responsibilities in your life right now?

  3. What are your major interests?

  4. What are your future plans and dreams?

  5. How do you feel about the way your life is right now?

  6. What words would you use to describe yourself?

  7. What words would your friends/family/supervisor use to describe you?

  8. What kinds of life changes have you experienced, including losses, relationship changes, family and friendship changes, or health, education, or self-awareness changes?

  9. Who has been a role model or mentor to you in your life? How?

  10. What kinds of influences do you think are good for children nowadays? Why?

  11. What kinds of influences are bad for children nowadays? Why?

  12. Who or what do you think is the most important influence in children's lives?