Mentor/Volunteer Application

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

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


Mentor/Volunteer Application Part I

Please complete all applicable fields.


List; Name, Age, Relationship (one person per line)
List; Name, Age, Relationship (one person per line)

I am interested in applying for the: (Check all that apply)
*Note family match and 2-2-1 Buddies each adult must complete an application

List; Name, Offense, Date (one per line)
List; Name, Offense, Date (one per line)

Please complete the Request for Driving check authorization below.

SCHOOL-BASED MENTORS ONLY: DISREGARD INSURANCE QUESTIONS

Car Insurance: Mentors/Volunteers are required to have automobile insurance and must carry auto liability limits with a minimum of $300,000 combined single limit or split limits of $100,000/$300,000.


REFERENCES:

Please list the names, addresses and phone numbers of three people who can vouch for your reputation, character and morals and who have known you for at least one year. If employed, please include present employer, regardless of length of employment. If you do not work, use another personal reference. Do not use relatives. 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.

Full Name, Please

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