Promise Mentor Application

Nevada Promise Scholarship

CSN is seeking mentors of all backgrounds who are willing to give 3-5 hours each semester to guide the future of Nevada: our youth. Mentors must be 21 years of age, willing to provide information to conduct a criminal background report and able to participate in one mandatory training session.

CONTACT INFORMATION
If your "Company" is not listed above, please enter it below:
EMPLOYEE DETAILS
Are you a CCSD employee? If yes, you will be prompted to enter information about CCSD.
Please provide the name of the school you work at:
Are you a CSN employee? If yes, you will be prompted to enter information about CSN.
As a CSN Employee, which campus do you spend the most time at?
CREDENTIALS
Please list each degree on a separate line:
How did you year about the Nevada Promise Mentor Program?
PREFERENCES

We will pair mentors and students based on preferrences as much as possible, however, we ask that Mentors maintain flexibility as this may not always be possible.

Preferred days to meet:
Preferred Times of day to meet:

Mentors can be paired with up to 10 students in one academic year. CSN recommends that each Mentor commit to no more than 3 to 4 students as a manageable number.

REFERENCES
REFERENCES 1
First Name *
Last Name *
REFERENCES 2
First Name
Last Name
AGREEMENT

*ACKNOWLEDGEMENT AND BACKGROUND CHECK RELEASE: (All applicants must complete mandatory training and complete a background check. Please initial your approval to do so below)

By submitting this form I agree to allow CSN to share my contact information with my Nevada Promise mentees and other relevant parties. I understand that when possible mentors will be matched to mentees based on career interests but due to the quantity of mentees, matching may need to be conducted on a random basis.

Mentor Qualifications:

  • The law that created the Promise Program requires all potential mentors to undergo a criminal background check. A person convicted of a felony cannot serve as a mentor.
  • Mentors must be 21 Years of age.
  • Mentors may not employ the person being mentored.
  • Mentors may not be related by consanguinity or affinity within the third degree to the students being mentored.
  • Mentors also may not be compensated for their service.

Acknowledgement and Background Check Release

  • I acknowledge that a criminal background check is required by Nevada law to participate as a Promise Program mentor. I authorize the College of Southern Nevada to work with a third party vendor to conduct a criminal background check.
  • If for any reason I do not meet the background check requirements, the College of Southern Nevada will inform me in writing and will provide me with the information of the third party vendor so that I may contact them for further information.
  • I agree to complete the mentor application and authorize the background check electronically.

Employees of identified and verified partner organizations that conduct criminal background checks as a condition of employment, may be exempt from submitting to an additional background check. Employers will be notified of the desire of employee to apply to the program and will certify their employment and background check.

If my employer is one of the identified partners, I hereby authorize CSN to communicate with my employer to verify that I meet the requirements of criminal background check established for the Promise Program. I do so by electronically authorizing the verification with my initials below.

Having read the above, I submit this application electronically by clicking the submit button below.