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CRANSTON ENTOR PROGRAM
Community Mentor Application
Please forward signed application with a photocopy of your driver’s license to:
Arlene McNulty Cranston Mentor Program 3296 Post Road Warwick, RI 02886
Name of Applicant: ________________________________________________ Date of Birth: ____________
Home Address: ___________________________________________________________________________
City________________________ State_______ ZIP___________ Number of years at this address_________
Previous Address__________________________________________________________________________
Home Phone: ______________________________ E-mail Address: _________________________________
Business Name & Address: __________________________________________________________________
Work Phone (ext.): __________________Fax: ______________E-mail Address: _______________________
Current Position Title: ______________________________________________________________________
I would like to participate as a traditional school based mentor, spending one hour a week in a school setting,
building a one-to-one relationship with a student who needs a positive role model.
I would like to participate as a literacy mentor with a student in grades K-4 working to enhance their reading skills,
increase comprehension and help them to develop a love of reading. With just a half hour or so of the regular
mentoring session dedicated to the "interactive read aloud".
Do you prefer working with: Boy Girl No preference
What grade level(s): K-6 7-8 No preference
Current job responsibilities: __________________________________________________________________
________________________________________________________________________________________
Description of career background and skills: _____________________________________________________
________________________________________________________________________________________
Have you ever worked with children before? Yes No If yes, in what capacity? ___________________
________________________________________________________________________________________
Please describe any special interests that may be helpful in matching you and your mentee (i.e. stamp
collecting, roller skating, computers, football, music, painting, etc.):
________________________________________________________________________________________
________________________________________________________________________________________
Please briefly explain why you would like to become a mentor: ______________________________________
________________________________________________________________________________________
How did you hear of our program? ____________________________________________________________
Additional information or comments ___________________________________________________________
________________________________________________________________________________________
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BCI __________
FP __________
TRNG __________
SCHL __________
SO CK
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