Agape Youth Mentor Application
What Is the Agape Mentorship Program?
Thank you for prayerfully considering joining the Agape Mentorship Program! Through our program, we hope to reach youth in Lane County who have accessed our program due to having a family member incarcerated at any time in their life. The program consists of the following mission and goals:
Mission: Facilitate the building of consistent relationships between children of incarcerated parents and positive role models. Through a deeper relationship with Jesus Christ, we hope to empower these youth with a sense of belonging and importance in their community while nurturing possibilities for a brighter future.
Share the gospel of Jesus Christ with all because we believe He is the real answer to all of life's needs.
Provide quality mentors who serve as healthy role models and develop long-term relationships that result in raising up disciples.
Equip youth through teaching and mentoring essential life skills as applied through a biblical worldview.
Help youth get connected to a local church body and/or youth group.
Provide a variety of platforms and resources for our mentors to support the fundamental needs of our youth in the following areas:
Avoidance of high-risk behaviors
1. Adult Friend
2. Positive Role Model
3. Nurturer of Possibilities
Please know that we take each application seriously as we work to set our youth and mentors up for success. After we have received your application our staff will review it and contact you to confirm your training. We take the security of the information you've provided seriously and appreciate you entrusting us. Thank you for your heart to serve these kids and their families! If you have any questions please contact us at: firstname.lastname@example.org.
Agreements & Releases
Please check "Yes" or "No" for each of the following releases.
Mission, Goals, & Roles
Agape Youth seeks to relieve suffering by providing stability and hope to at-risk youth ages 7-17 through practices listed above.
Mission, Goals, & Roles
I have read and understood the mission, goals, and roles of the Agape Mentorship Program.
Description: Mentors are positive role models who give a portion of their time, energy, and prayer to the pursuit of encouraging youth towards a deeper relationship with Jesus Christ.
Time: Minimum of one-year commitment with at least one hour of contact per week with your mentee.
Qualifications & Skills:
-Agree with Agape Youth Core Values and Principles
-Have a personal relationship with and commitment to Christ Jesus
-Maintain a lifestyle that is a positive role model for kids
-Participate in a life of a local church
-Be willing and able to take time to be with kids outside of Agape events
-Be willing to follow the leadership and direction of the Agape Staff
-Ability to communicate with kids and teens openly and non-judgmentally
-Sensitivity to persons of different educational, economic, cultural or racial backgrounds
-Complete on-line training
-Complete in-person training
-Fill out periodic surveys and report any pertinent information to Mentorship Coordinator
-Attend ongoing mentor training and support sessions (optional, but encouraged)
-Attend monthly Mentorship Night with mentee (optional, but encouraged)
-Facilitate mentee attending church (optional, but encouraged)
-Make a minimum 1-year commitment to developing and maintaining a mentor relationship with your youth
-Meet with mentee on a regular basis to establish trusting relationship
-Communicate regularly with guardians, mentee and Mentorship Program Coordinator
I have read and understood the Agape Youth Mentor Description.
The Mentorship Program requires you spend a minimum of four hours per month (an average of one hour per week) with your mentee for a school or calendar year. This may be fulfilled through activities of your choice. We highly encourage and recommend Agape Youth Nights, facilitating attendance to youth group, and/or Church attendance.
I have read and understood the levels of commitment for the Mentorship Program.
Imitators of Christ:
Love regardless of response
Spirit of excellence
Love means we go last
Treat others with respect
Demonstrate proactive service
Don't take yourself too seriously
Enjoy your work
I have read and understood the core values of Agape Youth.
Statement of Faith
The mission of Agape Youth is to bring the Gospel of Jesus Christ, through word and deed, to children who have been affected by the incarceration of a parent and the challenging life circumstances that brings forth. Staff and volunteers each bring with them a diversity of Christian experience, but we are unified that Agape Youth is not to be used as a platform to forward our secondary theological persuasions, but to focus on the simplicity and clarity of the Gospel.
These core beliefs are agreed upon by all in order to maintain unity amongst the staff and volunteers:
The Bible: We believe that the Bible is the Word of God and is the trustworthy and infallible authority in all matters of doctrine, faith and conduct.
The Trinity: We believe in one God, creator and sustainer of all things, eternally existing in three distinct persons, Father, Son and Holy Spirit.
Jesus Christ: We believe Jesus Christ to be God’s only begotten Son, eternal, conceived by the Holy Spirit with two inseparable natures, one human, one divine. He alone is the Savior of the world, having lived in sinless perfection, his death was a substitutionary atonement for sin providing forgiveness to all who believe.
Humanity: We believe God created man in His image, without sin. Adam sinned, and in him, we are all born into sin, both in nature and by deed. All humanity stands in need of God’s mercy and grace in order to be reconciled to Him.
Salvation: We believe that justification (salvation) is provided wholly by God’s grace and is received solely through faith in Jesus Christ, not as a result of any good works. We believe that the Holy Spirit indwells every believer at the moment of salvation, He is committed to our sanctification and He seals us until the day of our glorification. Good works are the fruit of salvation and will be evidenced in the life of the believer.
Statement of Faith
I have read and understood the Agape Youth Statement of Faith.
Code of Conduct
-Mentors are required to fill out and sign all paperwork, including Faith & Conduct Policy, Statement of Faith and Background check. These are all prerequisites in order to work with youth.
-Mentors must not enter into a counseling relationship with youth of the opposite sex -- In other words, guys work with guys and girls work with girls.
-Confidentiality is very important. All information shared with the mentor about the mentee or mentee’s family is confidential unless stated otherwise by the mentee.
-Ask for mentee’s parental and/or Agape Families supervisor’s approval when participating in activities where the mentee’s physical/mental abilities to safely perform duties are in question (i.e., swimming, skiing/snowboarding, rock climbing, horseback riding, skateboarding at the skatepark rollerblading, etc).
-You should never find yourself in a compromising situation with a child; if you need to talk to the child privately, make sure you are seen in view of other people.
-Mentors must not have mentee at a personal house of residence unless it is previously approved by Agape Youth supervisor or if there are other individuals present.
-Mentors must exercise utmost care regarding physical contact with kids, and understand when “light” touching or hugging is inappropriate. At no time should you touch a child that crosses personal boundaries. No tickling, wresting, sitting on laps, back rubs, or touch games.
-Mentors must not date youth, youth’s friends, or youth’s family members.
-Mentors should be alert to the physical and emotional state of their mentee. If there are any signs of injury or suspected child abuse or neglect, appropriate reporting procedures need to be followed.
-If the mentor has reasonable cause to believe that a child has suffered from physical/sexual abuse or neglect, the mentor should report it to Agape Youth staff immediately.
-If mentors have a physical or mental limitation, mentors must be able to interact with the mentee in a safe and appropriate manner or make arrangements to do so otherwise.
-Mentors must maintain appropriate behavior in their own personal relationships, including abstaining from the intimate sexual contact reserved for marriage, and must not display any form of intimacy while mentee is present.
-The mentors use of illegal drugs, at any time, is strictly prohibited.
-Alcoholic beverages and tobacco/nicotine are not to be consumed at any time during the day that the mentor is with the mentee.
-The giving of mentor's prescription drugs, essential oils, energy drinks, highly caffeinated beverages to a child is prohibited. The giving of non-prescription drugs is only permitted with the mentee’s legal guardian’s consent.
-Mentors must not currently be in treatment for alcohol or substance abuse and have at least three years of continual sobriety. Mentors must not be currently in treatment for a mental disorder or hospitalized for such in the past three years.
-Physical or corporal punishment is prohibited.
-No cussing, verbal abuse, coarse joking, sarcasm, sharing intimate or traumatic details of one’s personal life, and any kind of harassment, including-
physical abuse– to strike, spank, shake, slap;
verbal abuse– to humiliate, degrade, threaten;
sexual abuse– to inappropriately touch or speak;
mental abuse– to shame, be cruel;
neglect– to withhold food, water, basic care, etc.
-Never put youth in a situation that is embarrassing, uncomfortable, dangerous, or otherwise inappropriate for a child.
-Should a mentor have a personal social networking page (i.e., Facebook) and choose to be “friends” with a youth, make sure to alert the Mentorship Coordinator.
Code of Conduct
I have read and understood the Agape Youth Code of Conduct Agreement.
I, the mentor, hereby give permission for my picture and/or likeness to be used for Agape Youth promotion and advertising, including, but not limited to, brochures, newspaper or magazine articles, and the Agape Youth website.
Which Agape Youth Mentorship Program are you interested in?
Mentor First and Last Name
(Email is our primary way of communication with you about updates and upcoming events.)
American Indian/Alaskan Native
Hispanic or Latino
Native Hawaiian and Other Pacific Islander
Have you previously filled out an Agape volunteer application?
This is required for all mentors.
Is there a specific child that you have met within Agape that you have a heart for mentoring?
Please answer the following questions to the best of your ability to help us get to know you.
Do you have any prior experience being a mentor?
If you answered "Yes" to the previous question, please provide brief description.
Please list a few of your hobbies/interests. This will help the process of pairing you with a youth.
When people come to you with a personal problem you tend to:
When sharing your own story you tend to:
Share everything right up front
Be willing to share once I get to know someone
Open up only to my closest friends and family
On a scale of 1 to 5, how important is it for you to keep a calendar for your personal life?
1: I don't use a calendar
5: I use a calendar for everything
Please list any experiences you've had working with kids and general dates associated.
Part of the Mentorship Program is a periodic mentor report on your time with your youth. Which option describes your availability to complete it?
I don't have time to report weekly
I have a busy schedule but can take 10 minutes to fill it out each week
I will have no problems filling out the report each week
What church do you consider your church home?
Please describe any involvement you have with your church (serving, small groups, etc.).
Pastoral Reference Name:
Pastoral Reference Phone:
Pastoral Reference Email:
Signature of Mentor
Please include your full name and date. Note: By signing, you acknowledge that you have read and agreed with each item in this application and that the information provided is correct to the best of your knowledge.
Send me a copy of my responses
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