Mentorship Application Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

FITGirl, Inc. is an equal opportunity employer. Federal and state laws prohibit discrimination in employment related opportunities due to race, creed, religion, age, sex, national origin, or physical handicap. No question on this application is asked, or will be used, for the purpose of limiting or excluding any person’s right of consideration for practical or volunteer opportunities.

For more information about the Spring 2020 Mentorship Program, please email cheri@fitgirlinc.com and type "Mentorship" in the subject line. Thank you!

Full Name *

Date of Birth *

YYYY

Driver's License No. *

Home Address (Include Zip Code) *

School (HS, University, College) or Place of Business *

Phone *

Email Address *

Do you object to FITGirl, Inc running a background check? *

Yes

Maybe

List three people you would like to use as character references. Include phone and relationship. *

Please list previous work or volunteer experiences with youth, length of time and age of children. *

Please list any special skills, certifications, talents, hobbies or interests. *

Why do you want to be a FITGirl, Inc Mentor? *

I hereby certify that the aforementioned statements are true and correct to the best of my knowledge. I hereby grant FITGirl, Inc permission to verify such answers. I understand that any false statement on this application may be considered as sufficient cause for rejection of this application or for immediate suspension of the practical or volunteer experience. *

Yes

Required

Mentorship Terms (Please check each that apply) *

Attend two (2) hour orientation which will prepare you to work as mentor/volunteer.

Attend any additional training provided by FITGirl, Inc or 3rd party to help provide the best service possible to all students.

Follow all policies, rule and procedures provided at orientation.

Be professional at all times including posts on social media sites.

Promote FITGirl, Inc and help share posts and program information.

Agree to meet with mentee for up to 2 hours each week for a period of 8 weeks.

If you cannot attend one of the group gatherings, it is your responsibility to find a replacement for the day and notify both FITGirl, Inc and Mentee.

Required

Confidentiality Statement (Checking each statement is a confirmation that you understand and agree to each question.) *

In normal course of my volunteer/mentor assignment and responsibilities, I understand that I may have access to or view information regarding clients and employees. With regard to all such information, I agree to observe FITGirl, Inc. strict standard of confidentiality. I further agree that knowledge and information of a confidential nature, gained through my involvement with FITGirl, Inc. may not be used, distributed or discussed outside of my volunteer responsibilities.

I understand and agree that breach of such confidentiality shall subject me to disciplinary action, up to and including discharge.

I hereby attest that I have read this Confidentiality Statement and agree that my continued mentor/volunteer service is contingent upon strict adherence to same. I understand, and agree, that I will be discharged, should I violate FITGirl, Inc. standard of strict confidentiality.

Required

Print Name and Date *

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of FITGirl, Inc.. Report Abuse

Forms