The Future Is Mine: Mentor Application Form

Workplace Alumni/Mentor Volunteer Interest Form

First Name:
Last Name:
Email Address:
Job Title:
Career Area/Field/Category:
Company or Organization Name:
Company or Organization Address:
Company or Organization City:
Company or Organization State:
Company or Organization Zipcode:
Company or Organization Phone:
Company or Organization Fax:
Website Address:
	What type of education, training and/or experience do you need to get into this field?
Experience Needed:

	Please list the most common job duties in this field?
Job Duties:
Workplace Mentor/Volunteer Interest

How often would you be interested in volunteering your time to help high school students explore careers?


In what capacity would you be interested in helping high school students explore careers?
	Allow a student or students to interview you about you job/career choice.
	Host a student or students at your place of work for career day.
	Visit a school or schools and sit on a panel of speakers for a career day.
	Visit a school or schools to present information about you and your career journey.
	Host a group of students to explore all career options at your place of work.

Does your company provide internships?

If so, at what level?

Does your company currently offer scholarships to high school students who are interested in pursuing a career field that is offered at your workplace?

Does your company currently offer education reimbursement to its employees who are interested in pursuing a career field that is offered at your workplace?

Do you think your company would be willing to get more involved in helping high school students explore the careers that are offered at your company?

If so, who would the contact person be to find more out about this?
Contact Name:
Contact Phone:
Contact Email:



Are you a TFIM Alumni?

	Submit Workplace Mentor Form.