Teen Mentor Application - Chabad of Bradenton

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B"H

CHABAD HEBREW SCHOOL OF THE ARTS –
TEEN MENTOR APPLICATION & AGREEMENT FORM

Thank you for your interest in becoming a Teen Mentor at Chabad Hebrew School of
the Arts! Our Teen Mentors play a vital role in supporting our students with warmth,
professionalism, and responsibility.
Teen Mentoring takes place on Sunday, from 9:50 am-11:50 am.
Please complete the form below:
Full Name:
First Name Last Name
Birth Date:

Month Day Year
Gender:

MaleFemale
Phone Number (Teen):
Email (if applicable):
Parent/Guardian Name(s):
Parent Contact Number:
Jewish Learning Background
Hebrew Reading Proficiency:

NoneBeginnerIntermediateAdvancedFluent
Previous Jewish Education (if any):
Why Would You Like to Be a Mentor? Please share in 1-3 sentences why you are interested in being a Teen Mentor at Hebrew School:
Anything We Should Know? (e.g., allergies, accommodations, preferences, etc.)
References

Please provide two references (non-family members) who know you well and can speak to your character and responsibility.
Reference 1
Full Name:
First Name Last Name
Relationship to you:
Phone Number
E-mail
Reference 2
Full Name
First Name Last Name
Relationship to you
Phone Number
E-mail
Permissions & Conduct Agreement

By signing below, I agree to the following terms as a Teen Mentor at Chabad Hebrew School of the Arts:
- I feel capable and responsible enough to be a mentor to younger children.
- I agree to maintain professionalism, kindness, and respect in my interactions with students, staff, and peers.
- I understand there is absolutely no physical contact permitted with students.
- I give permission for photos and videos of me to be taken and used in school-related publications and marketing.
- I understand that cell phones are not permitted during Hebrew School hours.
- I understand that any behavior or object that distracts me from my role will result in termination of my position as a Teen Mentor.
I have read and understand the expectations above.
Teen Signature:
Date

Month Day Year
Parent/Guardian Signature
Date

Month Day Year
I would like to receive news and updates by email
Should be Empty:

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Reference 1

Reference 2

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