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1. Mentor Application & Preferences

This first page is to collect information that will be used as a way for Continuing Vision to contact you as well as your mentees. We will verify with all mentors before giving out any contact information. Please make sure that any names and/or titles are entered how you would like them displayed on your Mentor profile.

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* 1. Name

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* 2. Mailing Address (Will not be given out to mentees)

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* 3. What language(s) do you speak?

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* 5. Phone

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* 6. If you're planning to use a third-party app for communication (WhatsApp, GroupMe, etc.) please include the app name and username/number.

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* 7. Preferred Method of Contact from Mentees

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* 8. Please list any social media links that you want listed for mentees to access.

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* 9. What is your current role in funeral service?

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* 10. How long have you been in Funeral Service?

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* 11. What license(s) and/or certifications do you currently hold?

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* 12. What states do you currently hold a funeral service license in?

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* 13. What other education/certifications (outside of funeral service) do you hold and/or have held?

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* 14. Which days are you available? (Select all that apply.)

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* 15. How many hours per week could you dedicate to the program?

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* 16. What topics would you feel comfortable mentoring on?(Select all that apply.)

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* 17. What topics would you NOT feel comfortable mentoring on?(Select all that apply.)

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* 18. Why do you want to be a mentor?

Mentor Questionnaire
The following questions are not all guaranteed to be on your mentor profile. We may use different answers for different mentors. This is just to give us an idea of who you are and to put together a profile for future mentees to learn more about their possible mentor. Please give as much detail as you feel comfortable with, but the more information...the more detailed of a profile.

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* 19. The Infamous Question: What made you choose funeral service?

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* 20. What part of funeral service gets you the most excited and why?

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* 21. What has been your favorite part about being in funeral service?

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* 22. What is one thing you wish you could go back and tell your newly licensed self?

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* 23. If you could change one thing about the funeral profession, what would it be?

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* 24. What funeral professional (past or present) do you look up to and why?

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* 25. Did you have a good mentor? If so, tell us about them.

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* 26. What is a Fun Fact about you?

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* 27. What are some of your hobbies outside of work?

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* 28. What did you want to be when you were younger?

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* 29. Please Upload a Profile Picture (Headshot)

PNG, JPG, JPEG file types only.
Choose File

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* 30. Upload any additional photo that you'd like to share (family, hobby, professional, teaching, workplace, article promo, etc)

PNG, JPG, JPEG file types only.
Choose File
Thank you for your interest in becoming a Mentor!
Please allow us time to review the application, and we will reach out to you soon!
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