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2018-2019 Mentor Application

Thank you for signing up to be a Winning Futures Mentor. Please note: signing up does not guarantee a spot. Final selection will be based on matching of gender and interests. You must be 24 years of age or older to mentor with Winning Futures' high school students and our one-hour mentoring sessions take place during the work day.

Please contact Kathy Morgan at (586) 698-4387 or kathy@winningfutures.org if you have questions.

Thank you!

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* 1. Please complete your information (please note we must have your home address information):

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* 2. Which email do you prefer we use?

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* 3. What is the best way to connect with you on social media? (Please list handle or username)

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* 4. What is your gender?

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* 5. Please indicate your racial/ethnic group(s)-if multiple, please list in other

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* 6. Please check your age group

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* 7. How did you find out about mentoring with Winning Futures?

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* 8. If a certain person referred you to apply, please list their name below so we can thank them. (mentor, Winning Futures staff, board member, co-worker, etc.)

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* 9. I understand that it is protocol for Winning Futures to request that I have a State of Michigan background clearance (iChat, MI Sex Offender and Central Registry) and national background clearance through Verified Volunteers completed as a part of the mentoring process. 

I understand that the personal information submitted is used to search against criminal identification records from the Michigan State Police (MSP). I also understand that the personal information obtained is required by the Central Records Division of the Michigan State Police, Lansing, MI, to obtain a conviction only criminal history file search.

I hereby authorize the release of any records to the person or agency listed, along with the assigned school district. I understand that the agency is not obligated to assign me or continue my assignment if, in their professional judgment, it would not be in the best interest of myself or the person served by the agency. I authorize Winning Futures to utilize the above information for the sole purpose of obtaining a conviction only criminal history file search rerun this check every year that I am a volunteer.

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* 10. Please list your emergency contact information

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* 11. Please disclose any medical conditions you have that we should know about in case of emergency.

Thank you for your interest in becoming a full time mentor with Winning Futures!

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* 12. Which of the following locations are you available to mentor? Check all that apply.

  Cass Technical High School (I-75 & Grand River Road) Community High School (16 Mile Road & Ryan Road) Mumford High School (McNichols & Lodge Fwy) Harper Woods High School (I-94 & Vernier Road) Madison High School ( I-75 & 11 Mile Road) Pontiac Academy for Excellence (Baldwin Road & Woodward Loop) Warren Mott High School (I-696 & Dequindre Road)
First Choice
Second Choice
Third Choice

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* 13. Please check all of the times you are available for the one-hour class, not just your top preference. We will not know final times until the fall.

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* 14. If we are unable to match you with students at one of the schools you listed, would you like to be on a list of substitute mentors?

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* 15. Are you an alum of any of our schools or school districts (see the above list)?

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* 16. Were you a student in the Winning Futures program when you were in school?

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* 17. Are you able to mentor for at least 20 one-hour sessions from October through May during the workday between 7:30am and 1:30pm?

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* 18. How certain are you that you can fulfill your time commitment as a mentor for the duration of the program?

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* 19. Do you understand that Winning Futures is a curriculum-driven program with set activities and structure?

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* 20. Have you ever been terminated or otherwise disciplined, placed on probation, or warned not to continue engaging in certain conduct while volunteering with any agency? If so, please explain.

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* 21. Please list other careers you have had and your educational background.

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* 22. Please list any other organizations in which you participate. (Fraternities, sororities, volunteer or professional organizations etc.)

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* 23. Please list your hobbies, skills and interests.

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* 24. Please list any languages you speak other than english.

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* 25. Please list someone we can contact for a Professional Reference

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* 26. Please list someone in your personal or professional network who could serve as a substitute mentor for you if you are absent.

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* 27. Have you ever applied to mentor or been a full-year mentor with Winning Futures in the past?

Thank you for completing our mentoring application! Make sure to click the "Done" button below. We will reach out in June when we begin recruiting for the 2019-2020 school year. Thank you so much for your volunteerism!
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