Mentor Sign-Up

Thank you for your interest in becoming a mentor with Memphis Youth Development Group. We are committed to creating a safe, supportive, and empowering environment for all young people.

Minimum Eligibility Requirements

Be 21 years of age or older
Consent to and pass a fingerprinted criminal background check, including screening for offenses involving children
Agree to abide by all program policies, child safety protocols, and mandatory reporting obligations

Personal Information

First Name *

Last Name *

Date of Birth *

Email *

Phone *

Residential Address *

Motivation & Goals

What motivated you to apply as a mentor? *

What do you hope to gain or learn from mentoring?

Eligibility & Safety

I certify that I am 21+ years old. *

I consent to undergo a full fingerprinted background check for child safety clearance. *

I agree to complete mandatory child safety and program training sessions. *

Have you ever been arrested, charged, or convicted of a criminal offense involving a minor? *

No Yes

If Yes, please explain:

Certification & Signature

By signing below, I acknowledge and consent to the following:

I authorize MYDG to conduct a fingerprinted background check and verify my eligibility to work with minors.
Any false statements or omissions may result in denial or termination of involvement.
I agree to comply with all mentorship program guidelines, child protection policies, and mandatory reporting obligations.

I certify that all information provided is accurate and truthful.

Full Name (as signature) *

Date Signed *

Your application will be sent directly to our team.

✓

Application Submitted!

Thanks for signing up! We look forward to having you join our community.
A member of our team will reach out with next steps.

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