MEN OF VALOR

MENTOR APPLICATION

THE JERICHO PROJECT

This form sends an e-mail to Men of Valor.

Date:

Driver's License #:

Name:

Date of Birth:

Address:

City:

State:

Zip Code:

Home Phone:

If married, your wife's name:

If married, is your wife supportive of your volunteering as a mentor?

Yes
No

Occupation/Job Title:

Employer and Address:

Business Phone:

Cell Phone:

E-mail Address:

Latest Book Read:

Hobbies:

Church Membership:

Pastor:

Church Phone:

List Three references, their relationship to you and their phone number.
We need one of these to be either your pastor or Sunday School teacher.

Do you have previous experience in serving as a mentor or spiritual counselor to men in prison?

Yes
No

If yes, explain.

On occasion, sharing God's word will be an important part of the time you spend with your inmate. Please rate your knowledge of the Scriptures:

Good
Fair
Limited

How did you learn about Men of Valor?

Why do you want to serve as a mentor to men in prison, or what drew you to this work?

What are some expectations for yourself and the inmate you will be mentoring?

How and when did you become a follower of Jesus?

CCA requires all volunteers to complete a two-hour orientation/training session. Would you be willing to participate?

Yes
No

If you agree to serve as a Mentor, would you be willing to invest one to one and one-half hours per week with your inmate?

Yes
No

Every Mentor will be required to complete Mentor training. Are you willing to complete this training?

Yes
No

Have you been convicted of a crime?

Yes
No

If yes, explain.

You may also print this form by entering your information and clicking here.

Mail printed applications to the Men of Valor Office:

Carl Carlson
MEN OF VALOR
1420 Donelson Pike
Suite B-6
NASHVILLE, TN 37217