Apply to be a Mentor - Berkeley Community Fund

Name*

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Email*

Ethnicity

Asian
Black/African American
Hispanic/Latino
Middle Eastern
Native American
Pacific Islander
White
Two or more races
Other

Age Range

Address*

Street Address Address Line 2 City State ZIP Code

Cell Phone*

How did you hear about our program?

Occupation*

Employer*

Employer Address*

Street Address Address Line 2 City State ZIP Code

Please list any college(s)/universities where you received a degree and what your degree was in*

Are you the first to graduate college in your family?*

Yes
No
Other

What are your hobbies and special interests?*

Why do you want to become a mentor?*

Do you have any prior mentoring experience and/or experience working with young adults? If yes, please provide a short description of this experience.*

What do you believe you bring to the mentor relationship that will benefit a scholar?*

If you had an important adult in your life in your teenage and/or college years, what are the qualities that you appreciated most in that relationship?*

Phone

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