application • Spero Family Services

Mentor Application

This form is for individuals interested in establishing a one-on-one mentoring relationship with one of our residents. Mentors provide guidance, support, and encouragement to help residents on their personal journey. To qualify, mentors must be 21 years or older and willing to undergo both a background check and fingerprinting as part of the application process. For more information or assistance, please contact Ranee Kujawa at 618-242-1070 ext. 1236 or email her at .

Full Name*

Street Address*

City*

State*

Phone*

Date of Birth*

Do you have a valid Drivers License?*

Yes
No

Email*

How did you find out about Spero Family Services

List Previous Volunteer Experience

Organization/Agency:

Volunteer Position:

Duties:

Organization/Agency:

Volunteer Position:

Duties:

List special skills or background that make you a good volunteer:

Volunteer Interest:

References:

Please list two references that are not related to you.

1. Name:*

Address:*

Telephone:*

Relationship*

2. Name:*

Address:*

Telephone:*

Relationship*

Volunteer Commitment:

How often would you like to volunteer?

Weekly

Please select days available

Monthly

Please indicate days available

CAPTCHA

I understand that the mentor program involves spending a minimum of one hour every two weeks with your assigned mentee.

Yes

I understand I will need to have a background check for one on one mentoring.

Yes

Name

This field is for validation purposes and should be left unchanged.