Mentor Application

SafeHouse Outreach Mentoring Program … reaching tomorrow’s future today

Please complete the form below to apply for the SafeHouse Mentoring Program:

Contact Information
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  2. (valid email required)
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  12. The SafeHouse Mentoring Program is dedicated to providing an environment of consistency in the lives of the children we serve. Please be open-minded to the specifications and variables of the program. We will do our best to matching you with the best suited child.
References
  1. Please list the names and contact information of two persons who can attest to your maturity, sense of responsibility and sensitivity such as colleagues, business associates, pastors, community leaders or relatives (use 1 only). These references must have known you for at least 2 years.
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Additional Information
  2. I hereby give SafeHouse Outreach authorization to perform a state and federal background check to qualify my participation in the SafeHouse Mentoring Program. I agree that SafeHouse may disclose any or all information obtained during the application process. I also give SafeHouse permission to use my image for any promotional materials to promote their programs.
 

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