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Scholars Program Mentor Application

Scholars Program Mentor Application

As a mentor in the Clark State Scholars Mentoring Program, I will:

  1. Commit to meet with my assigned group of scholars once a month for 45 minutes up to an hour, October – May.
  2. Commit to participating in the program for at least one year, with the intention of taking a group of ninth grade scholars through to their high school graduation.
  3. Share positive and supportive guidance and be intentional about developing relationships of trust and respect with my group of mentees and co-mentor(s).
  4. Notify the Mentor Coordinator and my co-mentor if I must miss a scheduled meeting with my group, at least 24 hours in advance, or as soon as possible in case of an emergency.
  5. Contact the Mentor Coordinator as soon as possible if I must resign as a mentor so that alternate arrangements can be made.
  6. Complete the initial mentor training. If unable to attend any required or recommended trainings, I will notify coordinator for alternate arrangements.
  7. Agree to not to give or receive any gifts from a scholar or their family members.
  8. Agree to not coordinate any offsite field trips or meetings with scholars.
  9. Agree not to develop romantic relationships with any scholar, their parents, or their family members.
  10. Agree to adhere to the program's policies as described under the “Unacceptable Behaviors”, "Confidentiality” and “Mandatory Reporting of Child Abuse and Neglect" sections of the Mentor Eligibility and Requirements Policy.
  11. Agree to contact program staff should I experience any difficulties in the mentoring program, including relationship problems with scholars or their parents.
Personal Information

Please enter "N/A" if this doesn't apply to you.
Interest and Availability

Please check all that apply.

Please check all that apply.
Career Information

Please indicate if retired and list your former job title.

i.e., board member, community organization member, etc. N/A if none