Mentor Application

Page 1

Thank you for your interest in becoming a mentor.  Please provide the following preliminary information. 
Volunteer Information












If not employed, enter your current status (ie. retired, self-employed, unemployed)



Please choose only one


Page 2



School-based Locations
Please indicate 1st, 2nd and 3rd choice by making your selections below (pick distinct school names):



Page 3

Background clearances are part of the Screen Process.  Please select clearances obtained within the past 12 months:




Page 4

As training is an important part of becoming a mentor, the program requires three hours of introduction to mentoring and understanding culture and diversity issues.  We offer both day and evening training sessions which are held at The Mentoring Partnership of Southwestern Pennsylvania and United Way of Southwestern Pennsylvania.

The Mentoring Partnership of Southwestern Pennsylvania (TMP)
One Hope Square, 1901-1915 Centre Avenue
Pittsburgh, PA  15219
412-281-2535
www.mentoringpittsburgh.org

The United Way of Southwestern Pennsylvania (UW)
1250 Penn Avenue, 1st Floor
Pittsburgh, PA 15222
412-261-6010
www.unitedwaypittsburgh.org

The Consortium for Public Education (TCFPE)
1100 Industry Road
McKeesport, PA 15132
412-678-9215