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About Us
Our Programs
Get Involved
Locations
Events
- Host An Event
Blog
Contact
Give Now
Give Monthly

WANT TO BE A PART OF THE CHANGE?
Dare to Dream Mentor application

* Indicates required field

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Area(s) willing to serve (Check all that apply): *

Brinnon Chimacum Nordland Port Hadlock/Irondale Port Ludlow Port Townsend Quilcene

Would you be willing to travel up to 30 minutes? *

Email *

Phone Number *

Date of birth *

Gender *

Male Female Prefer not to answer

Have you ever served as a mentor before? *

Yes No

What age range would you like to mentor? *

11 - 14 (Dare to Dream Jr.) 15 - 22 (Dare to Dream)

Have you volunteered in other youth-serving organizations? If yes, when and reason for leaving? *

Ethnicity *

Hispanic/Latinx Native American/Indigenous Asian/Native Hawaiian Black/African American Multiracial White/Caucasian Non-disclosed/unknown

Bilingual? *

Yes No

If yes, please specify which languages you speak. *

Education *

Some High School Completed High School Some College Associate's Degree Bachelor's Degree Master's Degree PhD

Employment *

Unemployed Part-time Full-time Self-employed

Employer/School Name *

Occupation *

Bio (background, life experiences, interests) *

Would you be willing to complete a background check (and if required by agency, CPR/First Aid Certification, fingerprinting, & TB testing)? *

Yes No

Would you be willing to provide references? *

Yes No

SKILLS, TRAINING, EXPERIENCE (Please check all that apply): *

Spanish-speaking Office/Clerical/Computer Musical Ability Education Military Background Math/Science Photography Sports/Athletic Media/Newspaper Fundraising Newsletter/Written Communication Public Speaking Business/Banking Medical/Medicine Sales/Marketing Arts/Drama/Dance Clergy/Ministry Law Enforcement/Judicial Counseling/Social Work Legal Nutrition Other skills, training and talents

Submit

IF YOU ARE UNABLE TO SUBMIT THIS FORM, EMAIL THE REFERRAL TO MORGAN@OLYMPICANGELS.ORG

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info@olympicangels.org
PO Box 654
Port Townsend, WA 98368

WANT TO BE A PART OF THE CHANGE?Dare to Dream Mentor application

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WANT TO BE A PART OF THE CHANGE?
Dare to Dream Mentor application