Scholarships, Mentors and Hope > Request for Information: Mentors | Mentor Monthly Communication Form | Mentor Information Update

Mentor Information Update

Name *


First	Last

Address *

City *

State *

Zip *

Home Phone *

(xxx) xxx xxxx

Cell Phone

(xxx) xxx xxxx

Work Phone

(xxx) xxx xxxx

Email

Please check applicable comment

I am currently an active mentor (meeting with student minimum 3 times monthly) and wish to continue with this student in the next school year
Scholar Name

I am currently an active mentor but wish to mentor an alternate student

I am not currently matched with a scholar or my current scholar is a senior, and prefer to start with the next school year

I am no longer able to mentor at this time, but retain my name for the future

I am no longer able to mentor, delete my name off mentor list

I would like to be a 'Mentor Buddy'*

I know a potential mentor!

Mentor Name

Phone

*Mentor Buddy is a new assistance program for new mentors. Each new mentor will be assigned a "Mentor Buddy" for assistance within their first three months, ideally assigned to the same school. A "Mentor Buddy" will be there to assist (if needed) with the first visit and/or be available to answer questions of the new mentor.


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