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Become a Mentor

Please complete application below.

Please read this carefully before signing:
MCIP Mentoring Program appreciates your interest in becoming a mentor. Please initial each of the following:
_______ I agree to follow all mentoring program guidelines and understand that any violation will result in suspension and/or termination of the mentoring relationship.
_______ I understand that MCIP Mentoring Program is not obligated to provide a reason for their decision in accepting or rejecting me as a mentor.
______ (optional) I agree to allow the MCIP Mentoring Program to use any photographic images, videos, or recordings of me taken while participating in the mentoring program. These images may be used in promotions or other related marketing materials.
I understand I must return all of the following completed items along with this application, and that any incomplete information will result in the delay of my application being processed:
Information Release Form
Personal References Form
Interest Survey Form
DCPS Screening Procedure, including:
(i) A Child Protection Register (CPR) check
(ii) A Sex Offender Registry (SOR) check
(iii) screening for criminal background
(iv) mandatory drug and alcohol testing
(v) TB screening and other health risks
(vi) fingerprinting
By signing below, I attest to the truthfulness of all information listed on this application and agree to all the above terms and conditions.