The Children's Village

Mentor

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Mentoring Activities Corner

Mentoring Applications and Forms

Mentoring Screening Process

FAQ

Back to Be a Volunteer

Mentor Application

TO THE WORLD YOU MAY BE JUST ONE PERSON·BUT TO ONE PERSON YOU MAY BE THE WORLD!

To become a mentor, or for more information, complete the form below. We'll be in touch shortly.

(All fields are required) Top of Form

Full name:

Street Address:

Address 2 :

City:

State:

Zip:

Date of Birth:

/ / (mm/dd/yy)

Home Phone:

Cell Phone:

Email:

Employer (enter none if unemployed):

Occupation:

Employer Street Address:

Employer City, State, Zip:

Supervisor's Name:

Work Phone:

Emergency Contact:

Emergency Contact Phone #:

How did you learn of The Children's Village Mentoring Program?

Have you volunteered with other organizations within the past 10 years?

yes
no

If yes, then...

Personal attributes and/or reasons for wanting to volunteer with foster care youth:

Days Available (check all that apply):

Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

Hours Available (check all that apply):

Mornings
Afternoons
Evenings
Flexible

For which program(s) are you applying?

School-based
Community-based

Reference Information:

Please provide the name, address and phone number of 3 references. Do NOT include relatives:

Have you ever been convicted of a crime?

yes
no

If yes, please explain.

Do you have a valid driver's license?

yes
no

State:

Do you have an automobile?

yes
no

A fingerprint check, DMV check and clearance from NY State Central Registry are required for any individual volunteer position involving unsupervised off-campus trips with boys. this will be done confidentially through CV's Human Resources Dept. Photo IDs will be provided. A drug screening and tuberculosis (TB) test will be administered by our Medical Services Department. Proof of TB screening within the past 12 months will be accepted.

Do not click "submit" unless you agree to the following:
I certify that all of the above information is true and accurate and give my permission to contact the above-named references.

*required fields Bottom of FormFor more information about The Children's Village Mentoring Program or other volunteer opportunities, please contactCandida T. Fitts , Director of Volunteer Services
at (914) 693-0600 ext. 1586 or cfitts@childrensvillage.org