Mentor Application

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This application will help Walk With Sally know more about you and your interests. In turn, this will help us best match your interests with a child (mentee). Once your Mentor Application is submitted, WWS Program Staff will be notified, and someone will reach out to discuss next steps.  Thank you for your interest and we look forward to you joining the Walk With Sally team!
Personal Information















Please List All Members of Your Household:




















Current Employment History 










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Application Questions
Please answer all of the following questions as completely as possible. If more space is needed, use an extra sheet of paper or write on the back of this page.

General Questions:










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Criminal History









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Mentor Interest Survey
What are the most convenient times for you to meet with your mentee? (example: weekday evenings, M-W-F afternoons, weekends, etc.)













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Information Release








Please list any other cities, states, and dates of residency during the past 10 years.
















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Personal References


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