Connect. Mentor. Empower.

Contact Information

Please give your current address & phone number below.

Phone* (format xxx-xxx-xxxx)
Email*
Confirm Email*
Country
State / Province*
Address
City
Date of Birth (xx/xx/xx)*
Gender*
If you selected "other" please specify:
T Shirt Size*
  • Small
  • Medium
  • Large
  • Extra Large
  • XX Large
Name of mentor who referred me ("N/A" if not applicable)
If student, major/area of study ("N/A" if not applicable)*

Personal Reference

Please provide us with one professional reference. This person cannot be a family member. If we cannot reach this person we will be contacting you for another reference option.

Name of Reference*
Relation to Applicant*
Reference Phone Number (please use dashes: xxx-xxx-xxxx)*
Reference Email

Availability

Which day(s) of the week are you able to participate in One2One mentoring? Please select all potential times. All schools are located in Brooklyn Park, MN.

Program Availability*
  • Monday: 8:00 - 9:30am
  • Tuesday: 8:00 - 9:30am
  • Tuesday: 1:25 - 3:00pm
  • Wednesday: 8:00 - 9:30am
  • Thursday: 8:00 - 9:30am
  • Thursday: 1:25 - 3:00pm
  • I cannot mentor at this time, but please contact me in the future.
Transportation*
  • I have transportation to/from mentoring & I'm able to give rides
  • I have transportation to/from mentoring, but I cannot give rides
  • I will need to arrange transportation for myself

Background Information

Please note that your responses won't necessarily impact your ability to mentor.

Have you ever been charged with a felony or misdemeanor?*
  • Yes
  • No
If yes, please provide some additional information about the situation.
Have you ever been accused (rightly or wrongly) or investigated for sexual improprieties with a minor?*
  • Yes
  • No
Have you ever been abused (e.g. sexually, physically, emotionally, etc.)?*
  • Yes
  • No
If yes, please comment on your recovery process.

Thanks for filling out the One2One Mentor Application. Once you click submit you will receive a confirmation email telling you how to set up an interview with us!

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