{"id":75,"date":"2020-05-21T11:03:38","date_gmt":"2020-05-21T15:03:12","guid":{"rendered":"https:\/\/www.adelphi.edu\/nursing\/?page_id=75"},"modified":"2023-01-12T14:49:59","modified_gmt":"2023-01-12T19:49:59","slug":"become-a-mentor","status":"publish","type":"page","link":"https:\/\/www.adelphi.edu\/nursing\/hands-on-learning\/peer-mentoring\/become-a-mentor\/","title":{"rendered":"Become a Mentor"},"content":{"rendered":"<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]> *\/\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_28' style='display:none'>\n                        <div class='gform_heading'>\n                            <p class='gform_description'>Please answer these questions carefully. They will be used to skillfully match you with a student who has like interests. All responses will be kept confidential and files will be kept secure.\r\n<p>You can also\u00a0<a href=\"https:\/\/www.adelphi.edu\/nursing\/wp-content\/uploads\/sites\/12\/2020\/05\/CNPH-Peer-Mentoring-Program-Application-MENTOR.pdf\" target=\"_blank\">download the application form<\/a>\u00a0as a PDF. The completed application can be submitted via emailor printed and mailed to the contact below.<\/p><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_28'  action='\/nursing\/wp-json\/wp\/v2\/pages\/75' data-formid='28' novalidate><input type=\"hidden\" name=\"adelphi_gf_data\" value=\"1:local-28c9daa58be4ac8edf88b1c27993953d:1776083417\"><input type=\"hidden\" name=\"adelphi_gf_hmac\" value=\"77d3154ebf18dbd0d41a3b381634de5cb4d21d0811ef56aeb818aa579a7e7873\">\n                        <div class='gform-body gform_body'><div id='gform_fields_28' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_28_2\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_28_2'>\n                            \n                            <span id='input_28_2_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_2.3' id='input_28_2_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_28_2_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_28_2_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_2.6' id='input_28_2_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_28_2_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_28_3\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Pronoun<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_28_3'>\n\t\t\t<div class='gchoice gchoice_28_3_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='she\/her'  id='choice_28_3_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_28_3_0' id='label_28_3_0' class='gform-field-label gform-field-label--type-inline'>she\/her<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_28_3_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='he\/him'  id='choice_28_3_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_28_3_1' id='label_28_3_1' class='gform-field-label gform-field-label--type-inline'>he\/him<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_28_3_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='they\/them'  id='choice_28_3_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_28_3_2' id='label_28_3_2' class='gform-field-label gform-field-label--type-inline'>they\/them<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_28_3_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='ze\/hir'  id='choice_28_3_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_28_3_3' id='label_28_3_3' class='gform-field-label gform-field-label--type-inline'>ze\/hir<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_28_3_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='Prefer not to specify'  id='choice_28_3_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_28_3_4' id='label_28_3_4' class='gform-field-label gform-field-label--type-inline'>Prefer not to specify<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_28_50\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Race\/Ethnicity<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_28_50'>\n\t\t\t<div class='gchoice gchoice_28_50_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='Hispanic\/Latino'  id='choice_28_50_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_28_50_0' id='label_28_50_0' class='gform-field-label gform-field-label--type-inline'>Hispanic\/Latino<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_28_50_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='Asian'  id='choice_28_50_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_28_50_1' id='label_28_50_1' class='gform-field-label gform-field-label--type-inline'>Asian<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_28_50_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='Black or African American'  id='choice_28_50_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_28_50_2' id='label_28_50_2' class='gform-field-label gform-field-label--type-inline'>Black or African American<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_28_50_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='Native Hawaiian or Pacific Islander'  id='choice_28_50_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_28_50_3' id='label_28_50_3' class='gform-field-label gform-field-label--type-inline'>Native Hawaiian or Pacific Islander<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_28_50_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='Indigenous Peoples of the Americas'  id='choice_28_50_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_28_50_4' id='label_28_50_4' class='gform-field-label gform-field-label--type-inline'>Indigenous Peoples of the Americas<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_28_50_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='White'  id='choice_28_50_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_28_50_5' id='label_28_50_5' class='gform-field-label gform-field-label--type-inline'>White<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_28_50_6'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='Prefer not to specify'  id='choice_28_50_6' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_28_50_6' id='label_28_50_6' class='gform-field-label gform-field-label--type-inline'>Prefer not to specify<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_28_5\" class=\"gfield gfield--type-phone gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_5'>Home Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_5' id='input_28_5' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_28_6\" class=\"gfield gfield--type-phone gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_6'>Cell Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_6' id='input_28_6' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_28_11\" class=\"gfield gfield--type-address gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_28_11' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_28_11_1_container' >\n                                        <input type='text' name='input_11.1' id='input_28_11_1' value=''    aria-required='true'    \/>\n                                        <label for='input_28_11_1' id='input_28_11_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_28_11_2_container' >\n                                        <input type='text' name='input_11.2' id='input_28_11_2' value=''     aria-required='false'   \/>\n                                        <label for='input_28_11_2' id='input_28_11_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_28_11_3_container' >\n                                    <input type='text' name='input_11.3' id='input_28_11_3' value=''    aria-required='true'    \/>\n                                    <label for='input_28_11_3' id='input_28_11_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_28_11_4_container' >\n                                        <input type='text' name='input_11.4' id='input_28_11_4' value=''      aria-required='true'    \/>\n                                        <label for='input_28_11_4' id='input_28_11_4_label' class='gform-field-label gform-field-label--type-sub '>State \/ Province \/ Region<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_28_11_5_container' >\n                                    <input type='text' name='input_11.5' id='input_28_11_5' value=''    aria-required='true'    \/>\n                                    <label for='input_28_11_5' id='input_28_11_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_11.6' id='input_28_11_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_28_14\" class=\"gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_14'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_14' id='input_28_14' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><fieldset id=\"field_28_15\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >What is your preferred method of communication?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_28_15'>\n\t\t\t<div class='gchoice gchoice_28_15_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='Phone (Home or Mobile)'  id='choice_28_15_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_28_15_0' id='label_28_15_0' class='gform-field-label gform-field-label--type-inline'>Phone (Home or Mobile)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_28_15_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='Email'  id='choice_28_15_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_28_15_1' id='label_28_15_1' class='gform-field-label gform-field-label--type-inline'>Email<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_28_16\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Current Academic Year<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_28_16'>\n\t\t\t<div class='gchoice gchoice_28_16_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='Junior'  id='choice_28_16_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_28_16_0' id='label_28_16_0' class='gform-field-label gform-field-label--type-inline'>Junior<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_28_16_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='Senior'  id='choice_28_16_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_28_16_1' id='label_28_16_1' class='gform-field-label gform-field-label--type-inline'>Senior<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_28_52\" class=\"gfield gfield--type-number gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_52'>Current GPA<\/label><div class='ginput_container ginput_container_number'><input name='input_52' id='input_28_52' type='number' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_28_17\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_17'>Please describe what strengths you will bring to this program.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_17' id='input_28_17' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_28_18\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_18'>Statement<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_18' id='input_28_18' class='textarea small'  aria-describedby=\"gfield_description_28_18\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><div class='gfield_description' id='gfield_description_28_18'>Write a brief statement on why you have chosen to participate in the Adelphi University Nursing Peer Mentoring Program for undergraduate students.<\/div><\/div><div id=\"field_28_22\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_22'>Why do you want to become a peer mentor?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_22' id='input_28_22' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_28_23\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >What days of the week are you available to volunteer as a Mentor? (Check all that apply)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_28_23'><div class='gchoice gchoice_28_23_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_23.1' type='checkbox'  value='Monday'  id='choice_28_23_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_23_1' id='label_28_23_1' class='gform-field-label gform-field-label--type-inline'>Monday<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_28_23_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_23.2' type='checkbox'  value='Tuesday'  id='choice_28_23_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_23_2' id='label_28_23_2' class='gform-field-label gform-field-label--type-inline'>Tuesday<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_28_23_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_23.3' type='checkbox'  value='Wednesday'  id='choice_28_23_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_23_3' id='label_28_23_3' class='gform-field-label gform-field-label--type-inline'>Wednesday<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_28_23_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_23.4' type='checkbox'  value='Thursday'  id='choice_28_23_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_23_4' id='label_28_23_4' class='gform-field-label gform-field-label--type-inline'>Thursday<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_28_23_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_23.5' type='checkbox'  value='Friday'  id='choice_28_23_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_23_5' id='label_28_23_5' class='gform-field-label gform-field-label--type-inline'>Friday<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_28_24\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >What is the best time for you to Volunteer? (Check all that apply)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_28_24'><div class='gchoice gchoice_28_24_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.1' type='checkbox'  value='Morning'  id='choice_28_24_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_24_1' id='label_28_24_1' class='gform-field-label gform-field-label--type-inline'>Morning<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_28_24_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.2' type='checkbox'  value='Afternoon'  id='choice_28_24_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_24_2' id='label_28_24_2' class='gform-field-label gform-field-label--type-inline'>Afternoon<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_28_24_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.3' type='checkbox'  value='Evenings'  id='choice_28_24_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_24_3' id='label_28_24_3' class='gform-field-label gform-field-label--type-inline'>Evenings<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_28_25\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p>Please list two references (please include at least one personal friend and one work reference) Note: letters of recommendation are not necessary, only contact information:<\/p><\/div><fieldset id=\"field_28_27\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Reference 1 Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_28_27'>\n                            \n                            <span id='input_28_27_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_27.3' id='input_28_27_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_28_27_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_28_27_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_27.6' id='input_28_27_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_28_27_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_28_31\" class=\"gfield gfield--type-address gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Reference 1 Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_28_31' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_28_31_1_container' >\n                                        <input type='text' name='input_31.1' id='input_28_31_1' value=''    aria-required='true'    \/>\n                                        <label for='input_28_31_1' id='input_28_31_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_28_31_2_container' >\n                                        <input type='text' name='input_31.2' id='input_28_31_2' value=''     aria-required='false'   \/>\n                                        <label for='input_28_31_2' id='input_28_31_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_28_31_3_container' >\n                                    <input type='text' name='input_31.3' id='input_28_31_3' value=''    aria-required='true'    \/>\n                                    <label for='input_28_31_3' id='input_28_31_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_28_31_4_container' >\n                                        <input type='text' name='input_31.4' id='input_28_31_4' value=''      aria-required='true'    \/>\n                                        <label for='input_28_31_4' id='input_28_31_4_label' class='gform-field-label gform-field-label--type-sub '>State \/ Province \/ Region<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_28_31_5_container' >\n                                    <input type='text' name='input_31.5' id='input_28_31_5' value=''    aria-required='true'    \/>\n                                    <label for='input_28_31_5' id='input_28_31_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_31.6' id='input_28_31_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_28_32\" class=\"gfield gfield--type-phone gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_32'>Reference 1 Phone Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_32' id='input_28_32' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_28_29\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_29'>Relationship<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_29' id='input_28_29' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_28_30\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Reference 2 Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_28_30'>\n                            \n                            <span id='input_28_30_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_30.3' id='input_28_30_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_28_30_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_28_30_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_30.6' id='input_28_30_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_28_30_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_28_26\" class=\"gfield gfield--type-address gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Reference 2 Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_28_26' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_28_26_1_container' >\n                                        <input type='text' name='input_26.1' id='input_28_26_1' value=''    aria-required='true'    \/>\n                                        <label for='input_28_26_1' id='input_28_26_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_28_26_2_container' >\n                                        <input type='text' name='input_26.2' id='input_28_26_2' value=''     aria-required='false'   \/>\n                                        <label for='input_28_26_2' id='input_28_26_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_28_26_3_container' >\n                                    <input type='text' name='input_26.3' id='input_28_26_3' value=''    aria-required='true'    \/>\n                                    <label for='input_28_26_3' id='input_28_26_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_28_26_4_container' >\n                                        <input type='text' name='input_26.4' id='input_28_26_4' value=''      aria-required='true'    \/>\n                                        <label for='input_28_26_4' id='input_28_26_4_label' class='gform-field-label gform-field-label--type-sub '>State \/ Province \/ Region<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_28_26_5_container' >\n                                    <input type='text' name='input_26.5' id='input_28_26_5' value=''    aria-required='true'    \/>\n                                    <label for='input_28_26_5' id='input_28_26_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_26.6' id='input_28_26_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_28_28\" class=\"gfield gfield--type-phone gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_28'>Reference 2 Phone Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_28' id='input_28_28' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_28_33\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_33'>Relationship<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_33' id='input_28_33' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_28_34\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you speak a foreign language?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_28_34'>\n\t\t\t<div class='gchoice gchoice_28_34_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='Yes'  id='choice_28_34_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_28_34_0' id='label_28_34_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_28_34_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='No'  id='choice_28_34_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_28_34_1' id='label_28_34_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_28_35\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_35'>Please specify:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_35' id='input_28_35' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_28_36\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_36'>Please list any hobbies or interests you have:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_36' id='input_28_36' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_28_37\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_37'>What kind of activities would you like to enjoy with a mentee?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_37' id='input_28_37' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_28_38\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_38'>What clubs or groups, if any, do you belong to?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_38' id='input_28_38' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_28_39\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_39'>&quot;My favorite subject in school was&quot; (Complete this sentence)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_39' id='input_28_39' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_28_40\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_40'>&quot;My least favorite subject in school was&quot; (Complete this sentence)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_40' id='input_28_40' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_28_41\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_41'>What qualities would you like in a mentee?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_41' id='input_28_41' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_28_42\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_42'>What individual has served as a role model for you? Why?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_42' id='input_28_42' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_28_43\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_43'>If you could recommend one book for your mentee to read, what would it be and why?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_43' id='input_28_43' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_28_44\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_44'>Please write a brief statement about why mentoring is important:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_44' id='input_28_44' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_28_48\" class=\"gfield gfield--type-consent gfield--type-choice gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Digital Signature<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_48.1' id='input_28_48_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_28_48\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_28_48_1' >I agree<\/label><input type='hidden' name='input_48.2' value='I agree' class='gform_hidden' \/><input type='hidden' name='input_48.3' value='1' class='gform_hidden' \/><\/div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_28_48' tabindex='0'>I certify to the best of my ability that the information provided here on this application is true and accurate. 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