Mentor Registration FormWe appreciate your interest in becoming a mentor. The information in this application will help us to match you with mentees and will be kept confidential. Full name Email address* Your Phone Number * City * Zip code * Occupation * Company Gender * MaleFemale How did you find out about the Raven & Macaw Community? Mosque/ChurchMentorWebsiteBoard/staffOthers Would you agree to have us check your name through federal and state criminal records of child abuse and neglect proceedings? (Please circle) * YesNo List any special interests, skills or hobbies you have: List examples of any prior volunteer experience:
