Profile Documentation

Welcome to The Ammon Foundation and the Ammon Professional Mentoring Program.  Our goal is to connect our scholarship recipients (Ammon Recovery Scholars) with professionals in their field of study.

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* 1. Contact Information

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* 2. Why do you want to be a mentor with the Ammon Foundation?

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* 3. What strengths do you have that would make you a good mentor?

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* 4. You will be asked to upload your resume later in this document, however, is there anything not on your resume that you think may be helpful to match you with a mentee?

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* 5. Please state any preferences you might have regarding your potential mentee (i.e., gender, race, location, etc).

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* 6. Current Employer and Job Title

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* 7. Highest education attained?

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* 8. Date of birth

Date

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* 9. Gender

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* 10. Which race/ethnicity best describes you? (Please choose only one.)

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* 11. How did you first hear about the Ammon Foundation?

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* 12. Are you a Veteran?

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* 13. Recovery Anniversary (if you are a person in addiction recovery)

Date

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* 14. Upload your most recent resume

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
Choose File

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* 15. Disclaimer: By submitting this application and providing my electronic signature below, I hereby certify that the above information, to the best of my knowledge, is correct. I understand that falsification of this information may prevent me from being contracted or lead to my dismissal if contracted. I also provide consent for The Ammon Foundation to contact the personal references provided.

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* 16. Emergency Contact Information (in the event that we have an in-person mentoring activity and there is an emergency, we would like to be prepared with emergency contact information)

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