CIRCLE OF FRIENDS IMPACT SCHOLARSHIP
MENTOR APPLICATION FORM

 

 
MENTOR APPLICATION FORM
Please fill out the information below if you are interested in becoming a Circle of Friends Impact Scholarship Mentor in the lives of our young ladies/students. We have taken great consideration and care with our ask, because we understand the responsibility that comes with saying yes to such an important opportunity.
Date *
Date
Name *
Name
Address *
Address
Phone *
Phone
Are you able to commit to nine months?
Have you ever been charged or convicted of neglect or abuse of a child or adult?
Will you submit to a background check?