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PO Box 660252
Austin, TX 78766
18882995977
The SID Centers
Your Custom Text Here
Home
About
Our Mission/Vision
Our Mentors
Our Centers
Our Programs
Projects
TJJD - NV
Bravefest 19
Summer Indulge
Get Involved
Community Partnership
Join Us
Events
Contact
Donate
Potential Mentor Screening Intake Form
admin, please complete this P.m.s. intake form throughly & thoughtfully. The overall goal is to get to know our future mentors! Please check mark this section in the mentor onboarding doc.
Your Name
*
First Name
Last Name
SID Email
*
Todays Date
*
Date which P.M.S. is occurring
MM
DD
YYYY
Did you mention this call is being recorded?
*
Yes
No
Applicant Information Review
Please VERIFY This Information with them before moving to the next section.
Name
*
First Name
Last Name
Email
Phone
(###)
###
####
SCC
*
200 (Admin)
208 (LA County)
210 (Orange County - CA)
212 (Clark County)
222 (Dallas Area)
223 (Fort Worth Area)
224 (Travis County)
225 (Williamson County)
270 (Fulton County)
274 (Orange County - FL)
276 (Broward County)
264/265 (Wake County)
Home Address
VERIFIED?
*
YES
NO
QUESTIONS:
Tell me about a significant event(s) that have shaped your life?
*
What did you do well in school?
*
Who is the person in your life that you are closest to?
*
How would this person describe your personality?
*
What would others say that they do not like about you?
*
What continuously motivates you to keep moving?
*
Did/Do you have mentors? (Past/Current)
*
How do you feel about ethnic, religious, and racial differences that our Country/World faces today?
*
How open do you feel about sharing personal values and learning about the differences in values between the students?
*
Why do you want to be a mentor?
*
Do you understand the amount of commitment involved and believe that you can meet that?
*
Yes/No
What could hinder you in being a committed mentor?
*
Anything else you'd like to mention?
*
If you can think of any additional or follow up questions for them, please list the questions and their answers here
Not required but preferred
If they had any follow up questions that you could not answer, please list them here
Ask to see if they have any questions
How long did this session take?
*
15-30 min
31-45 min
46-60 min
61-90 min
At the end of the session, just mentioned to them that Administration will take the next couple days to review and our leadership team will be reaching out for further steps.
Thank you for this update!