AIM-Mentor Application

Welcome

Thank you for your interest in All In Mentoring’s (AIM) youth mentoring program and for completing this application. All information collected on this application will be kept confidential within the AIM mentoring program.

Are you over the age of 18? *This question is required.

If you are under age 18 we are unable to match you with a mentee at this time. Please contact us at Allinmentoringwsr@gmail.com to discuss other options to participate in our program.

Personal Information

First Name *This question is required.

Last Name *This question is required.

Date of Birth *This question is required. MM/DD/YYYY This question requires a valid date format of MM/DD/YYYY.

calendar

Do you agree to authorize the AIM program to check your background through federal and state agencies for criminal records and child abuse and neglect proceedings? *This question is required.

All in Mentoring requires that all of our volunteers have a background check on file. Please contact us for any questions you might have.

Address

Street Address *This question is required.

Apt/Suite

City *This question is required.

Zip *This question is required.

If you said other, please specify.

Contact Information

Email Address *This question is required. This question requires a valid email address.

Primary Phone Number *This question is required. Please provide a 10-digit phone number including area code.
Enter numbers only. Formatting such as dashes will be added as you enter your phone number.

Secondary Phone Number

Can we contact you at work? *This question is required.