Gladden Middle School Mentor Program
VOLUNTEER APPLICATION

Date: _________________

Name: _________________________________________________________________

Address: _______________________________________________________________

Home phone: ____________ Cell Phone: ____________ Work phone: ______________

Fax: _______________________ Email: ______________________________________

Male: _____ Female: _____

As a volunteer working with children, I agree to:

• Participate in a short introductory training session

• Commit as a mentor for one full academic school year

• Commit at least 30 minutes/week of my time to visit my mentee

• Alert the school when I am unable to attend a scheduled meeting

• Maintain confidentiality at all times

• alert Mrs. Sierra or school counselor of any concerns

Please indicate dates and times that you are available to meet with your mentee.

_________________________________      ________________________________

Day                                                                  Time

_________________________________      ________________________________

Day                                                                  Time

_________________________________      ________________________________