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2024 Summer New Y-WE Mentor Application
If you have any needs or questions, please contact Neli at
neli@y-we.org
.
Personal Information
Name
*
First Name
Last Name
Preferred first name (if different)
Pronouns (optional)
she/her, they/them, he/him, etc.
Birthdate
*
Please double check that the date provided is accurate! We need your name AND birthdate in order to run the required background check.
Email
*
Verify Email
*
Phone Number
*
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Do you have any dietary restrictions or food allergies? (for example: vegetarian, halal, allergic to peanuts, etc).
*
Are there any accommodations you need regarding physical space, allergies, environmental sensitivities, etc. or technology support needed to access our virtually-based programming?
*
Y-WE is dedicated to creating inclusive spaces and programs for all, including people with disabilities and specific accommodation needs.
Do you have any safety or medical concerns which will affect your ability to participate in specific activities during our programs?
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Occupation or School, if applicable
*
Please upload a picture of yourself that you like
Under 10 MB! If the file is too large the form will take a long time to process when you hit 'submit' at the bottom.
Interests and Experience
Your answers to these questions help us to get to know you better and understand what inspired you to apply to be a mentor at Y-WE. We shape our programs around the passions and goals of the women and youth who participate--so your answers to these questions really matter to us! This program is here to support YOU and our youth in the best way possible.
Which program(s) are you interested in mentoring for? Folks will only be paired with one program, but its helpful to know all the programs you're potentially interested in and available for.
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You can learn more about most of these programs here: https://youngwomenempowered.org/our-programs/
Create (7/8-14)
Grow Internship (Tuesdays-Fridays, 7/9-8/18, 9am-1pm, 6 weeks)
BIPOC Horse Camp (7/20-21 overnight)
Black Girls/Non-Binary Bike (7/29-8/2)
Grow Summer Camp (TBD, likely 8/5-8/9, 9:30am-12:30pm)
Write (8/5-11)
Refuge Outdoor Festival (BIPOC-centered, 8/16-18)
Black Mermaids (8/19-23)
An important part of mentoring with Y-WE is participating in mentor trainings. We ask that you commit to making those meetings a priority so that together we can create the best possible experience for youth participants!
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Got it! I can commit to making mentor meetings/trainings/check ins a priority.
How did you learn about Y-WE?
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Why is this a good time in your life to commit to being a mentor?
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What do you hope to gain or experience through mentoring in Y-WE’s programs? What are some of your personal goals?
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Do you have any mentoring or youth work experience? Please describe.
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Special skills, talents, qualifications, areas of knowledge, or field of expertise:
What size in tops, bottoms, and shoes do you wear?
Optional - this helps us buy or borrow gear for you if needed for your program
Do you have a current CPR/AED certification, and/or any advanced medical training? This is not required of mentors, it's just helpful for us to know in case there were ever an emergency at the program.
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Y-WE offers Equity Stipends for mentors who would otherwise be unable to volunteer their time. Would you like more info on the stipend? This has no bearing on the mentor selection process.
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select one
Yes
No
While not required, some mentors also support programs by transporting youth in personal or Y-WE vehicles. Are you willing to be a driver if needed? Y-WE can reimburse you for mileage! (select all that apply)
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Prospective drivers must submit appropriate documents before driving on behalf of Y-WE (license, insurance, etc). Driving support is one of the most impactful ways to help keep programs accessible to youth!
Yes, I'm willing to drive a personal vehicle on behalf of Y-WE
Yes, I'm willing to drive a Y-WE vehicle
I'm not sure
No, I'm not willing to be a driver
Is there anything you'd like us to know about your availability, interest, etc?
References
Please list two references who can comment on your interpersonal, mentoring, or professional skills.
Reference #1
*
First Name
Last Name
Relationship to You
*
Phone
*
Email
*
Verify Email
*
Reference #2
*
First Name
Last Name
Relationship to You
*
Phone
*
Email
*
Verify Email
*
Demographic Information
Y-WE collects this data to better understand our community, and to improve and obtain support for our programs. Your answers are confidential and will not be shared outside of Y-WE except as part of anonymous percentages.
Do you identify as Black, Indigenous, or a Person of Color?
*
select one
Yes
No
Prefer not to answer
Other
If you selected 'Other' please describe:
Race/Ethnicity (check all that apply)
*
American Indian or Alaska Native
Asian
Black
African American
African
North African
Hispanic or Latino/Latinx
Middle Eastern
Mixed Race
Native Hawaiian or Pacific Islander
White
Prefer not to answer
Other
If you selected 'Other' please describe:
Do you identify as LGBTQIA+?
*
select one
Yes
No
Other
Prefer not to answer
If you selected 'Other' please describe (optional):
Gender Identity (select any/all that apply, or select 'prefer not to answer')
*
Agender
Girl or woman
Boy or man
Non-binary
Genderqueer
Gender neutral
Two spirit
Cisgender
Genderfluid
Prefer not to answer
Other
If you selected 'Other' please describe (optional):
Primary languages(s) spoken at home (select all that apply)
*
English
Amharic
Arabic
Chinese
Khmer
Korean
Punjabi
Russian
Somali
Spanish
Tagalog
Tigrinya
Ukrainian
Vietnamese
Other
Prefer not to answer
If you selected 'Other' please describe:
Country of Origin (your answers are confidential and we do not ask about immigration status)
*
select one
I was born in another country and moved to the U.S.
I was born in the U.S. and one or both of my parents/guardians were born in another country
I was born in the U.S. and my parents/guardians were born in the U.S.
Prefer not to answer
Emergency Contact Info
Emergency Contact Name
*
First Name
Last Name
Relationship to You (parent, spouse, friend, etc)
*
Phone Number
*
Email Address
*
Verify Email
*
Residence (City and State)
*
Commitment to Y-WE
As a mentor, your consistent attendance is essential! Please check the dates of the program you are applying for to make sure you can attend most of the program, and make attending mentor trainings/meetings a priority. If you have questions about this, please contact us. A few reminders: by filling out this form you're giving Y-WE consent to run standard background checks; the situation with Covid continues to evolve and we'll ask everyone to follow Y-WE's safety policies and guidelines specific to the program/space/timing/etc; we ask folks to fill out updated Hold Harmless/Medical forms every year or so- we'll let you know if we need fresh ones from you.
I have read the above and I understand.
*
I have read the above and I understand.
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