Application Form

In order to assess your suitability as a mentor we ask you to answer a number of personal and private questions in as open and honest a manner as possible. All information provided will be held in the strictest of confidence.

Identifying Particulars

Full Names
Marital Status
Drivers License
Physical Address
Phone number

Date of Birth
ID Number
Postal Address
Confirm E-mail:

Education / Employment History

Your current employment status
Name of Employer
Job Title
Work Telephone
Business Hours
Length of Emploment


Name of school
Subjects Taken(1)


Name of institution
Subjects Taken

General Information

Have you ever been convicted of a crime?
If yes, please provide more information:
Are you willing to obtain a criminal background clearance?
What is the state of your health?

Background, Experience & Interests

Have you engaged in voluntary work before?
If yes, what form did this take and what time commitment did it require?
What experience do you have working with children?
What do you like to do during your leisure time?
Please describe yourself including your strengths and weaknesses
Please describe your family and home environment

You as a Mentor

Why do you want to be a mentor?
What about the Bright Stars mentoring initiative appeals to you personally?
What cultural, social or recreational activities do you enjoy that you would like to share with a mentee?
What kind of relationship do you imagine you would like to have with your mentor/mentee?
How will this help your personal development?
What do you expect to learn/ benefit from participating in this kind of relationship?
Is there any support from anyone else that would help your experience in this mentoring relationship?
If yes, please specify
What information (if any) would you like your mentee to know about you before you meet them?
What information (if any) would you like to know about your mentee before you meet them? (note that we are not furnished with much information as information is considered confidential between the homes and the mentees)
Can you meet with a child once a week for at least an hour?
Do you have a preference as to the age of your Little Star?
If yes, state your preference
Do you have a preference as to the geographical location of your Little Star?
If yes, where?
Are there any other comments you have, questions to ask, concerns, challenges or ideas you would like to share?
I attended training at
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