Free2Succeed

Community Mentor Application

Please complete this application form if you are interested in becoming a mentor for the Idaho Department of Correction. Mentoring is distinctly different from volunteering. Please review the Mentor information on our website to better understand the difference.

Once you complete the form, click the submit button at the bottom.
First Name:*field type single line
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Last Name:*field type single line
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Mailing Address:*field type single line
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Zip:*field type single line
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City:*field type single line
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State:*field type single line
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Home phone:field type single line
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Cell phone:*field type single line
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Email Address:*field type email
Age:*field type number
Gender:*field type radio button
Gender:MaleFemale
Gender:field type single line
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Personal Reference
Please list a personal reference you would like to use as character references. Only those you have known for more than a year qualify. If possible, please include at least one relative.
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- First name:*field type single line
  Input blocked. Maximum character limit of 4000 characters reached.
- Last name:*field type single line
  Input blocked. Maximum character limit of 4000 characters reached.
- City:*field type single line
  Input blocked. Maximum character limit of 4000 characters reached.
- State:*field type single line
  Input blocked. Maximum character limit of 4000 characters reached.
- Zip:*field type single line
  Input blocked. Maximum character limit of 4000 characters reached.
- Cell phone:*field type single line
  Input blocked. Maximum character limit of 4000 characters reached.
- Email:*field type email
- Relationship:*field type drop-down
Add second reference
How did you hear about Free2Succeed?field type drop-down
Do you have any criminal charges pending?*field type radio button
Do you have any criminal charges pending?YesNo
If you are on probation or parole, you may still be eligible to mentor but your PO will need to give permission to do so.
Are you on probation or parole?*field type drop-down
Criminal Historyfield type multi line
Please include any past drug use, length of sobriety, and if you are currently involved in some type of community-based and/or 12-step sober living program.
Why are you interested in mentoring an offender?field type multi line
Are you willing to mentor a sex offender?field type multi line
Mentor / Volunteer Experiencefield type multi line
Do you have mentoring or other volunteer experience? Please list where and when and what type of experience. For example, working with incarcerated and/or returning citizens, addiction recovery, mental health issues, or with the Idaho Department of Correction in some capacity.
Interestsfield type multi line
Do you have mentoring or other volunteer experience? Please list where and when and what type of experience. For example, working with incarcerated and/or returning citizens, addiction recovery, mental health issues, or with the Idaho Department of Correction in some capacity.
Religious Affiliationfield type multi line
Do you have a religious preference? If so, what religion or church? This is not required but does help us with matching you with a compatible participant.
What age group(s) are you interested in mentoring:field type checkbox
What age group(s) are you interested in mentoring:18-3031-4041-5050+
Mentor Initial Training and Orientation (ITO)field type multi line
It may not be feasible to attend an Initial Training and Orientation immediately but you can still begin mentoring provided you attend the next available training opportunity. Are you comfortable being matched before attending a Mentor Initial Training and Orientation?
Read the:
Mentor Position Description, Mentor Agreement, Confidentiality Agreement and Release of Liability.

I certify that I have read the above referenced documents and that all statements and information contained in this application are true and correct to the best of my knowledge. I understand that submission of this application does not guarantee that I will be matched with a participant and that working with Free2Succeed and the Idaho Department of Correction and any segment of the population that they serve is subject to approval of this application and the completion of any required training.
*field type radio button
I Agree
Date Submittedfield type date

Free2Succeed

Personal Reference