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SAM Mentor Application
Contact Information
Name
First Name
Last Name
Email
Verify Email
Address
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
References
Reference #1
*
Name, phone, email & relationship to you: i.e. PASTOR
Reference #2
*
Name, phone, email & relationship to you: i.e. PASTOR
Reference #3
*
Name, phone, email & relationship to you: i.e. PASTOR
Faith Section
Renew Hope is a faith based organization and it is important that our mentor volunteers share this core value. Please complete in detail.
Where do you currently attend church?
*
Name and location
What does Jesus Christ mean to you?
*
Family Section
Briefly describe your family (Spouse, kids &/or pets!
*
About "YOU" Section
Describe Your Professional Life
Or life experience that may contribute to your service as a mentor (including languages spoken and training in trauma informed care)
Do you consider yourself more of an introvert or an extrovert?
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Introvert
Extrovert
How do you typically cope when faced with stressful situations?
*
What are some activities that you enjoy?
*
Current Well-Being
On a scale of 1-10 How would you rate your current overall emotional well-being?
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select one
1
2
3
4
5
6
7
8
9
10
Why did you choose that rating for emotional well being?
*
On a scale of 1-10 How would you rate your current overall spiritual well-being?
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select one
1
2
3
4
5
6
7
8
9
10
Why did you choose that rating for spiritual well being?
*
On a scale of 1-10 How would you rate your current overall physical well-being?
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select one
1
2
3
4
5
6
7
8
9
10
Why did you choose that rating for physical well being?
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Have you experienced abuse/trauma of any kind in your past? If so, describe your healing journey
*
SAM Program
What are your hopes and expectations regarding your involvement in the SAM Program?
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What questions do you currently have regarding the SAM Program with Renew Hope?
*