Denver Urban Scholars Mentor Application


Thank you for your interest in becoming a mentor with Denver Urban Scholars.



Please note that this application must be completed in one sitting and takes approximately 15 minutes to finish. Please have your driver’s license, auto insurance, reference information and 3 years of residency history prepared before starting. Also your application will not timeout but clicking back on your browser will result in a loss of data.

If you have any questions regarding the online application please contact Candace Pruett at 303.355.1700. Thank you and we look forward to reviewing your application!


Anti-Discrimination Policy:

Denver Urban Scholars is committed to equal opportunity and does not discriminate against its employees, volunteer, member organization, clients or the public on the basis of gender, sex, race, creed, color, religion, disability, national origin, citizenship, age, sexual orientation, gender expression or veteran status.

This policy of nondiscrimination prevails throughout every aspect of employment, client and volunteer activities including recruitment, selection, placement, training, compensation, promotion, transfers, layoff, recall and termination.
Part 1: Contact Information
* First Name
Middle Name
* Last Name
* Email address
* Password
* Confirm Password
Primary Address 1
Primary Address 2
Primary City
Primary State
Primary Zip Code
Phone Number 1
Ext.
Phone Number Type
Phone Number 2
Ext.
Phone Number Type
Phone Number 3
Phone Number Type
Ext.
Date of Birth
Ethnicity
Gender
Foreign language
How did you hear about Denver Urban Scholars?
Place of Employment
Position
Length of Employment
Work Address 1
Work Address 2
Work City
Work State
Work Zip Code
Emergency contact name
Emergency contact phone
Relationship to you
Driver's License Number
Part 2: Matching Assessment

To help us match you with a scholar in our program, we would like to know a little about your personality and interests. Please note: if you do become a mentor, this information could be shared with your mentee.

Why do you want to become a mentor with Denver Urban Scholars?
Are you able to meet with a mentee 8-12 hours a month? This usually amounts to 2 meetings/month, weekly communication, and includes drive time to and from meetings.
How would you describe your communication style?
Other
What would you prefer in a student’s communication style?
Other
Give me an idea of a typical week day for you
Give me an idea of a typical weekend for you
Which of these activities do you enjoy?
Sports-If yes, list specifics
Outdoor Activities-If yes, list specifics
Games-If yes, list specifics
Arts/Crafts-If yes, list specifics
Computer/Technology-If yes, list specifics
Other Activities-If yes, list specifics
What is your highest level of education achieved?
What other information would you want your student to know about you
Part 3: Release of Information

References: Please list three people who know you well and can attest to your character, skills and dependability. Please include your current or last employer.

Reference 1 - Personal
First Name
Last Name
Relationship
Length of Relationship
Phone
Email
Reference 2 - Professional
First Name
Last Name
Relationship
Length of Relationship
Phone
Email
Reference 3 - Family
First Name
Last Name
Relationship
Length of Relationship
Phone
Email
Required Documents

If you have them available, please upload a photo of your driver's license and proof of auto-insurance. Should you not have them available now, we'll request them later once your application is approved.
Driver's License
No file is currently uploaded.
Upload File
Proof of Insurance
No file is currently uploaded.
Upload File

Please read the following carefully before signing this application:
I understand that this is an application for and not a commitment or promise of volunteer opportunities. I certify that I have and will provide information through the selection process, including on this application, for a volunteer position and in interviews with Denver Urban Scholars that is true, correct and complete to the best of my knowledge. I certify that I have and will answer all questions to the best of my ability and that I have not and will not withhold any information that would unfavorably affect my application for a volunteer position. I understand that information contained on my application will be verified by Denver Urban Scholars. I understand that misrepresentations or omission may be cause for immediate rejection as my application for a volunteer position with Denver Urban Scholars or my termination as a volunteer. Denver Urban Scholars reserves the right to terminate a volunteer for the program at any time.

I hereby consent to permit Denver Urban Scholars to contact anyone it deems appropriate to investigate or verify any information provided by me to discuss my suitability for a volunteer position, including my background, volunteer experience, education or related matters. I expressly give my consent to any discussions regarding the foregoing and I voluntarily and knowingly waive all rights to bring an action for defamation, invasion of privacy, or similar cause for action, against anyone providing such information.

I agree to let Denver Urban Scholars and/or the news media videotape, photograph or write print articles about me or which mention me. Such print articles may appear in Denver Urban Scholars newsletter or other news media. I release any and all rights, including any right to enumeration I may have in any such video, photograph and/or print articles.

The information contained in this application is correct to the best of my knowledge. I hereby authorize Denver Urban Scholars and its designated agents and representatives to conduct a comprehensive review of my background causing a consumer report and/or an investigative consumer report to be generated for employment and/or volunteer purposes. I understand that the following areas: verification of social security number; credit reports; current and previous residences; employment history; education background; character references; drug testing; civil and criminal history records from any criminal justice agency in any or all federal, state, county jurisdictions; driving records, birth records, and any other public records. I further authorize any individual, company, firm, corporation, or public agency (including the Social Security Administration and law enforcement agencies) to divulge any and all information, written or verbal, pertaining to me, to Denver Urban Scholars or its agents. I further authorize the complete release of any records or data pertaining to me which the individual, company, firm, corporation, or public agency may have, to include information or data received from other sources. **Denver Urban Scholars and its designated agents and representatives shall maintain all information received from this authorization in a confidential manner in order to protect the applicants personal information, including, but not limited to, addresses, social security numbers, and dates of birth.

* Date
* Applicant Signature
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