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  • CBM CARES® NATIONAL MENTORING INITIATIVE MENTOR APPLICATION

  • Contact Information

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  • Are You A Former CBM Volunteer?

  • Background Information

  • Have you ever been convicted or charged with an offense or crime against children?
  • Have you ever been charged with neglect, abuse or assault?
  • Have you ever been convicted or charged with a felony or misdemeanor?
  • Do you have any physical limitations or are you under any treatment that might limit your ability to perform certain types of work?
  • Do you give CBM consent to conduct a background check on you?
  • Do you give CBM consent to conduct a DMV check on you?

  • Mentor Information

  • Have you ever been a mentor before?

  • Availability

  • What times are you available to mentor (check all that appy)

  • References

  • Personal References

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  • Professional References

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  • Sport Interests?
  • 2. Arts Interests

  • Mentor Preferences for Match

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  • Willing to be matched with ayouth from a home environment with:

  • * CBM has the right to deny the participation of any applicant in our programs for any reason deemed appropriate by CBM staff.

    I hereby certify that all information provided on this application is true and complete.  I understand that falsification or significant omissions of any information may be considered justification for non-acceptance or dismissal if discovered at a later date.

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  • By submitting this application you agree to sign a hardcopy version of this application for CBM National records before participation in CBM Cares® Mentoring activities with children.  You also acknowledge that you understand, participation in the program requires a background check.

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