Mentor Sign- Up

Thank you for your interest in becoming a mentor with Memphis Youth Development Group. We are committed to creating a safe, supportive, and empowering environment for all young people. To uphold our standards of child safety and program integrity, all mentors must meet the following minimum eligibility requirements:

Be 21 years+
Consent to and pass a fingerprinted criminal background check, including screening for offenses involving children
Agree to abide by all program policies, child safety protocols, and mandatory reporting obligations

Must be 21+ and be able to pass a background check.

First Name

Last Name

Date of Birth

Your Email

Phone

Residential Address

What motivated you to apply as a mentor with our organization?

What do you hope to gain or learn from your mentoring experience?

I certify that I am 21+ years old.

I consent to undergo a full fingerprinted background check for child safety clearance.

I agree to complete mandatory child safety and program training sessions and understand that it is a requirement before I can begin mentoring for this organization.

Have you ever been arrested, charged, or convicted of a criminal offense involving a minor? Required

Yes

If Yes, please explain in great detail.

PLEASE READ:

By signing below, I acknowledge and consent to the following:

I authorize Memphis Youth Development Group to conduct a fingerprinted background check and verify my eligibility to work with minors.
I understand that any false statements or omissions may result in the denial or termination of my involvement.
I agree to comply with all mentorship program guidelines, child protection policies, and legal obligations, including mandatory reporting of abuse or suspected abuse.

Certification & Signature

I certify that all the information I have provided is accurate and truthful. I understand and agree to all legal and safety requirements associated with becoming a mentor.

Your Signature

Date Signed

Thanks for signing up! We look forward to having you join our community.

Mentor Sign- Up

Certification & Signature

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