Elementary School Mentorship Program

Mentorship Application Information

Phone Number

Have you ever mentored before?

Please tell us where you have been mentored.

Have you attended mentor training?

Please provide mentor training details.

Have you ever been convicted of a felony?

Please explain felony.

Have you ever had a founded Child Protective Services (CPS) investigation?

Education

High School

Dates Attended High School

College

Dates Attended College

Did you graduate college?

Employment

Company

Company Phone Number

Supervisor:

Job Title

Dates Employed

Military Service

Branch

List dates in the service.

Rank

Sign Here

First Name

Last Name

Choose how to sign

Draw Type

I certify that my answers are true and complete to the best of my knowledge. By signing this form, it advises you (Mentor) that you are agreeing to hold the City of Virginia Beach, The Virginia Beach Sheriff’s Office, The City of Virginia Beach Public Schools harmless of all injuries, damages and/or losses you incur as a result of volunteering to become a mentor and participating in mentoring activities. It also explains that as a mentor you are not considered an agent, employee or representative of the City of Virginia Beach or its affiliates/departments and therefore not covered under any state/agency insurance or Labor and Industries disabilities coverage for any expenses, injuries damages, or losses you incur as the result of your participation as a mentor. If this application is accepted, you will be notified by the email provided. Applicant agrees that any photos taken, or interviews conducted during the mentorship program may be used on all virginia beach city social media outlets.