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About Us
Our Mission
The Team
National Council
2020 IMPACT REPORT
Our Programs
Love Box
>
Program
Apply to Volunteer
Love Box Admin Area
Family Referrals
Dare to Dream
>
Program
Apply to Volunteer
D2D Admin Area
Youth/Dare to Dream Referrals
2020 Impact Report
Get Involved
Apply to Volunteer
>
Love Box
Dare to Dream Mentor
Give
>
Donate
Monthly Sponsorship
Employer Gift Matching
Partnerships
>
Faith Partnerships
Other Partnerships
Email Newsletter
Locations
Events
Host An Event
Blog
Contact
Give Monthly
Give Now
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