Go Girls Go! Mentor Application

We are so excited Go Girls Go will return to Shalom this spring. Thank you for your interest in being a mentor throughout this season. This would include committing to participating in meets at least once a week and running with a small group of girls and helping to keep them safe as we are off campus running. Mentors can be male or female and with all running abilities.

**You will need to provide a copy of your child abuse and criminal history clearances (less than 5 years old). Send your clearances to Administrative Secretary Jess Baldwin (adminsecretary@shalomca.com).

Your Namerequired

First Name

Last Name

Email Addressrequired

Home/ Cell Phonerequired

Preferred Contact MethodrequiredPlease select up to 1 choice

Text

Call

Please select up to 1 choice

Home Address:required

Birthdaterequired

necessary for race registration (Must contain a date in M/D/YYYY format)

I am a...requiredPlease select up to 2 choices

Parent

Teacher

Other

Please select up to 2 choices

Which school will you mentor at?required

I am a...required

Parent

Teacher

Other

This form is only for Shalom Christian Academy mentors.

I have the following clearancesrequired

Please select one.

What days are you able to commit? (Tuesdays and/or Thursdays-program begins at 3:30 pm.)required

Are you able to participate in the October 28 culmination 5k? requiredPlease select up to 1 choice

Yes

Please select up to 1 choice

Signaturerequired

Typing your name in the field will be equivalent to a signature.

Daterequired

Must contain a date in M/D/YYYY format