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Mentors
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Mentors

Contact at later date? *

Yes

No

First Name *

Last Name *

Gender *

Female

Male

Other

Prefer not to say

Combined Name Primary

Email Address *

Phone Number *

Textable? *

Yes

No

Alt. Phone Number

Alt. Phone Textable? *

Yes

No

Employer

Used for establishing corporate connections. This is NOT public.

Adult #2

Is there a second adult? *

Yes

No

Adult 2 First Name *

Adult 2 Last Name *

Adult 2 Gender *

Female

Male

Other

Prefer not to say

Combined Name Secondary

Adult 2 Email Address

Adult 2 Phone Number

Adult 2 Textable? *

Yes

No

Adult 2 Employer

Used for establishing corporate connections. This is NOT public.

Address *

Address

City

State

Zip

I/My Family would like to work *

1-on-1 with an individual or family

as part of a team working with a family

Do you feel comfortable working with someone with limited English? *

Yes

No

Language(s) Other Than English Spoken

Do you have other skills/experience enabling you to advise or support our work? *

Case Management/Family Support

Education

Evictions

Housing - Locating

Housing - Landlord Issues

Legal

Mental Health

Nutrition

Social Work

Software/Technology

None of the Above

How would you describe yourself/your family including experiences with people from different cultures? *

Is there anything else you'd like to share about yourself or family? *

How did you hear about Welcoming the Stranger? *

Hear About Name *

Please list a Reference

Reference First Name *

Reference Last Name *

Reference Phone Number *

Reference Email Address

Relationship *

Comments

Welcoming the Stranger periodically follows up with mentors by email and/or surveys. We expect that you will respond.

Terms and Conditions *

I understand and accept the above conditions.

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