Live RecoverED Peer Mentorship Program: Mentor Application 
Please answer the following as completely and honestly as you feel comfortable. This will best help us to best match our mentors and mentees. If for any reason you do not feel comfortable answering a specific question, please answer "n/a".
Email *
Are you currently behavior free? If so for approximately how long? 

(our preference is for mentors to be at least 2 years behavior free, if mentors are behavior free less than 2 years we will take this on a case by case basis for if they are able to be a mentor in our program.) 

If you are not behavior free currently, we encourage you to continue working at your own recovery and apply to become a mentor in the future :)
 *
This mentorship program is characterized by communicating with your mentee at least once a week for 6 months. (4 hours per month)

In addition to this, there is 4 hours of training along with monthly check ins with the peer mentorship coordinator of about 30-60 minutes per month. 

Please acknowledge below whether you can commit to the 4 hour training, 4 hours per month with your mentee, and the 30-60 minutes per month check ins. 
Clear selection
Name *
Age *
Email Address *
Phone Number *
Do you have a preference on the frequency of meetings with your mentee during the week?
Clear selection
What time zone are you located in?  *
Methods of communication you'd be interested in with your mentee (select all that you'd be interested in) *
Required
Are you Christian? If so, which denomination? *
Do you have any other specific experiences that you think may help a person struggling (BIPOC, woman, mother, Christian, current/former athlete, etc.)? 

We will try our best to accommodate shared experiences when pairing mentors and mentees.
 *
What is your availability/times willing to meet?
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
6am-7am
7am- 8am
8am-9am
9am-10am
10am-11am
11am-12pm
12pm-1pm
1pm-2pm
2pm-3pm
3pm-4pm
5pm-6pm
7pm-8pm
8pm-9pm
9pm-10pm
10pm-11pm
Do you think that you are able stable enough in your recovery to be a role model for someone currently struggling?  *
What have you struggled with in the past as it pertains to eating, exercising and body image?  *
Required
How long did you experience these symptoms? *
How old were you when you first started experiencing symptoms?  *
What does "recovered" mean to you? *
In what ways has your life improved since recovery? *
What can a mentee learn from you? *
Have you struggled (or currently struggle) with any other mental health issues or neurobiological disorders that you would be willing to share with your mentee?  *
Required
Do you or have you lived with any other physical health concerns that you would be willing to share with your mentee (chronic pain, IBS, food restrictions, diabetes, etc.)?  *
Do you have any other life challenges that you've experienced that you would be willing to share with a mentee (divorce, trauma, family issues, etc.)?  *
What age would you prefer your mentee to be? 

We will try our best to accommodate these preferences when pairing mentors and mentees.
 *
Do you currently or have you in the past identified as an athlete? *
If yes, what sport(s)? *
Do you identify as a person in a larger body? *
What are your hobbies and interests? How would your friends/family describe you? *
Is there anything else you would like to share? Would you like this to be shared with your mentee before your first meeting? *
Please read and complete the mentorship program contract (copied below) and send the contract completed to liverecovered@gmail.com. 

 *
You will receive an email from liverecovered@gmail.com within the next few days concerning next steps.  *
A copy of your responses will be emailed to the address you provided.
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