Mentor Sign Up

The TYSB, Brighter Paths Mentor Program, mission is to create a
brighter future for youth in our community by uncovering resilience,
empowering and reducing risk.

Fill out and submit the initial mentor application to become a
Brighter Paths Mentor Today!

For more information or questions about the program please contact Catharina Ohm: cohm@nwcty.org or

Judith Kobylarz-Dillard: thebereadyproject@gmail.com

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Personal Information

First and Last Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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Date of Birth

MM/DD/YYYY

Date

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Preferred Pronouns

She/her

He/him

They/them

Other

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Gender

Female

Male

Nonbinary

Other (please specify)

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Race and Ethnicity
Check all that apply

White or Caucasian

Black or African American

Hispanic or Latino

Asian or Asian American

American Indian or Alaska Native

Native Hawaiian or other Pacific Islander

Other (please specify)

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Employment Status

Employed, Full-Time

Employed, Part-Time

Retired

Not Employed

Student (please specify)

Mentor Sign Up

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Personal Information

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Date of Birth

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Preferred Pronouns

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Gender

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Race and Ethnicity
Check all that apply

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Employment Status

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Skills
Provide personal interests, skills, and reasons that will make you a good mentor

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Resume (optional)

Mentor Sign Up

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* Personal Information

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* Date of Birth

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* Preferred Pronouns

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* Gender

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* Race and Ethnicity Check all that apply

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* Employment Status

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* SkillsProvide personal interests, skills, and reasons that will make you a good mentor

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* Resume (optional)

Personal Information

Date of Birth

Preferred Pronouns

Gender

Race and Ethnicity
Check all that apply

Employment Status

Skills
Provide personal interests, skills, and reasons that will make you a good mentor

Resume (optional)