Mentor Application

2023

Thank you for your interest in helping empower young women by volunteering as a mentor for the Seeds of Hope Leadership Experience. Please complete this form and reach out to me if you have any questions.

Cheryl Hufnagel
724-650-7936 or CHufnagel@FelicianSisters.org

Your Information

First Name

Last Name

Phone

Street Address

City

State/Province

Zip

Date of Birth

References

Please provide two professional references (school or employment-related) and one personal reference.

Reference 1

Professional Reference:

Full Name

References 1

Job Title

Relationship to Applicant

Phone

Reference 2

Professional Reference:

Full Name

Job Title

Relationship to Applicant

Phone

Reference 3

Personal Reference:

Full Name

Job Title

Relationship to Applicant

Phone

Experience

Describe your previous experiences volunteering or working with youth:

List qualities, skills and other attributes that make you a good mentor:

Have you previously attended Seeds of Hope?

Yes

In what year, and in what capacity?

Waiver

Have you ever been arrested or convicted of a crime?

Yes

Have you ever been arrested, charged or convicted of child abuse, molestation or any other crime involving a minor?

Yes

Are you mentally and physically able to perform the responsibilites of mentoring a minor, with or without accommodations?

Yes

Will you commit to participate in the Seeds of Hope Mentor Program, July 5 -15, 2023 in Holly, Michigan?

Yes

I commit to uphold the Felician values of compassion, transformation, solidarity with the marginalized, respect for human dignity, and justice and peace.

I understand the Seeds of Hope Mentor Program is not obligated to provide a reason for their decision in accepting or rejecting me as a mentor.

I understand I will need to provide a valid driver’s license or official state ID. I will be asked to complete an Information Release Form and Mentor Interest Form and submit to a criminal background check including state clearances, and provide a certificate of completion of safe environment training.

I understand and agree that the relationship between me and Seeds of Hope and Felician Sisters of North America is as a volunteer, and does not create any type of employment or independent contractor relationship.

I understand I will not be compensated for acting as a mentor in the program, and that my participation is for volunteer purposes only.

I certify that, to the best of my knowledge, all of the information I have provided is accurate and complete.

Thank you. Your form has been sent.
We will be in touch with you.