High School Mentor Application

If you prefer you may download and fill-in the    Printable Application Form

Please provide the following information, to submit the form online.

High School Mentor Application


Please Check All That Apply:

CMC Program Interest:

Please Check Those of Interest:


We would like you to provide two references that would recommend you for our school-based mentoring program. Please choose references you know well. Please make one reference your parent and the other reference school personnel, such as a teacher, coach, guidance counselor, etc.
We will be making phone contact with your references, so please provide us, if possible, with a daytime and evening phone number.

Children’s Mentoring Connection of Hancock County reserves the right to deny a volunteer application when, in its sole discretion, it believes it is in the best interest of CMC to do so and is not obligated to match you with a child.


(Please Check the following Boxes to grant Parent Permission)

I hereby give the child named on this application permission to participate in the school-based mentoring program if accepted by the agency for inclusion.
I hereby authorize Children’s Mentoring Connection of Hancock County to make such investigation as they deem proper and necessary regarding my background and to determine the accuracy of the information I have furnished in this qualification record. Furthermore, I hereby release any Agency or organization from liability for cooperating with CMC of Hancock County by releasing the requested information.

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