Denver Kids - Public Portal
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Mentor Application Form

Denver Kids, Inc. considers information about our students, parents, guardians and mentors confidential and will not share the personal content of your application. As a member of the Denver Youth Mentoring Collaborative, Denver Kids, Inc. does release a list of mentoring applicants to avoid duplication and streamline communications among the Denver Youth-Mentoring community.

Important Note: Once you begin filling out this form, you will NOT be able to save your work and complete at a later time. It may be helpful to print the application and gather necessary information in advance.

Basic Information
* First Name
* Last Name
* Date of Birth
* Ethnicity
* Race
* Gender
* Address
* City
* State
* Zip code
Place of Employment
Work Address
Work City
Work State
Work Zip code
* Primary phone
Work phone
Work phone ext.
* Personal Email (Primary)
Work Email (Secondary)
Spouse First Name
Spouse Last Name
Match Information
* Describe your previous involvement with students.
* What strengths would you bring to the mentoring relationship?
* What do you hope to gain from the mentoring experience?
* Of the 4 organizational core values (courage to excel, integrity, lifelong learning and partnership), which most resonates with you, and which do you find most challenging?
* Grade Level Preference
Additional Information
* How did you learn about Denver Kids, Inc.?
* Please state who you heard about Denver Kids, Inc. from
* Please list how you heard about Denver Kids, Inc.
* Have you ever applied to volunteer in an organization working with children and been refused?
* If yes, please explain
* Have you ever been accused of child abuse, neglect, or child molestation?
* If yes, please explain
* Do you have a valid driver's license?
* Have you, in the last ten years, been issued a citation in connection with an alcohol or drug related offense under the motor vehicle code?
* If yes, please explain
* Do you have any physical or emotional health issues that could impact your relationship with a child?
* If yes, please explain
* Do you have any allergies (animals, smoke, etc) that might impact how we match you to a student?
* If yes, please note
* Have you ever had, or do you now have, a problem with drinking or substance abuse?
* If yes, please explain
* Have you been questioned, arrested, or had a complaint filed against you in connection with a crime?
* If yes, please explain
Personal Information
Work
* What I do for work
School
* Education level
* Study
* My favorite subjects were/are
* Do you speak a foreign language?
* Foreign language
* Fluency
* Other Language:
Personal Interests
Personal Interests
* InterestsPlease select the activities that you enjoy the most:
* Please explain your interests:
Emergency Contact
Contact 1
* Contact name
* Contact relationship
* Contact phone
Contact 2
* Contact Name
* Contact relationship
* Contact Phone
References

Please provide the names and email addresses of THREE references. (two personal & one business)

Reference 1
* First Name
* Last Name
* Relationship
* Phone
* Email Address
Reference 2
* First Name
* Last Name
* Relationship
* Phone
* Email Address
Reference 3
* First Name
* Last Name
* Relationship
* Phone
* Email Address
* I certify that all information provided herein is true and accurate. I understand that my application may be denied or my volunteer status immediately terminated if any information I have provided as part of this application process is found to be false.