LGI – MENTOR APPLICATION

APPLICANT INFORMATION

*Applicants must be 30 years of age on the date the application is submitted to The LifeGold Initiative (LGI).

EMPLOYMENT & EDUCATION

PREVIOUS VOLUNTEER EXPERIENCE

PERSONAL REFERENCES

*Please complete the reference section below by providing the contact information for (2) personal references of persons not related to you.

PROFESSIONAL REFERENCES

*Please complete the reference section below by providing the contact information for (3) professional references .

PRE-MATCH QUESTIONNAIRE (Responses are used for mentor/mentee matching)

BACKGROUND QUESTIONNAIRE

EMERGENCY CONTACT

ACKNOWLEDGEMENTS AND SIGNATURE

By signing and submitting this application you agree the following: Sharing of your Bio and other information contained in this application with LGI Executive Staff, and mentees, as necessary for matching purposes. To consult with the LGI Program Coordinator regarding any concerns about mentees, other LGI volunteers or staff, or any questions/concerns regarding the program in general. To demonstrate professionalism, good judgement and care in your capacity as a volunteer when interacting with mentees and their families, and other LGI volunteers and staff. To maintain confidentiality with regard to your interaction with mentees and their families and to only share sensitive information with the LGI Executive Staff. This extends to confidentiality on all virtual and social media platforms with the understanding that posting of mentees or their children or recordings of any kind are prohibited without prior approval. Mentee minors and Mentors may not be "friends" on any social media platform. Not to disclose, duplicate or distribute any information obtained through your affiliation with LGI, to friends, relatives, associates, or business entity, unless LGI has explicitly authorized such disclosure, duplication or distribution, or unless such disclosure is required by law. To follow all program policies and guidelines with the understanding that violation will lead to termination of the mentoring relationship and participation in all LGI programs and events.
Type your legal name above to sign the application.
A copy of your resume, bio and professional photo will be requested upon acceptance of your application.
*If you provided a cell phone# above, our team will send updates about LGI programs and events via text message.