MENTOR APPLICATIONAll potential mentors must also complete this application, a training and orientation, and background check. If you have questions, please contact Mentor Coordinator, Greg Haney at haneygr@tulsaschools.org. Name * First Name Last Name Date of Birth * MM DD YYYY Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Cell Phone * (###) ### #### Email Facebook Name Twitter Name Instagram Name (Or any other social media) Emergency Contact * First Name Last Name Emergency Contact Phone * (###) ### #### Highest Education Completed * High School College Post Graduate Other School Name and Area of Study * Current Employer Job Title * Length of Time in Position * Hobbies and Areas of Interest * What motivated you to become a mentor? * List two people, other than relatives, who we might contact as a reference. * First Name Last Name Phone * (###) ### #### Second Reference * First Name Last Name Is there anything else you'd like us to know about you? Additional questions? Email haneygr@tulsaschools.org. Thank you!
