Tilled Soil • Mentor Application
Mentor Information Form
Contact Information
Full Name
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Email Address (Primary)
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Phone Number
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Preferred Communication Method
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Location (City, State, Time Zone)
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Professional Background
Current Occupation (Job title and organization)
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Years of Professional Experience
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Areas of Expertise
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Career Highlights (Briefly list top 2–3 achievements or milestones)
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Professional Certifications (if applicable)
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Educational Background (Schools, degrees, certifications, or training)
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Mentoring Experience & Approach
| Have you mentored before? |
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If yes, please describe your past mentoring experiences.
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How would you describe your mentoring style?
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What is your approach to mentoring?
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What motivates you to mentor young girls in under-resourced communities? (Short answer)
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How would you respond if your mentee is struggling emotionally or disengaged?
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Availability & Format
How many hours per week or month can you commit?
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| Are you available for the full program duration (8–10 months)? |
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| Preferred Mentoring Format: |
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| Preferred Meeting Time(s): |
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Pillars of Mentorship – Areas of Confidence & Passion
Which of the Tilled Soil mentorship pillars do you feel most equipped to guide mentees in?
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Please elaborate on your strengths or experience in each selected area.
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Cultural Competency & Lived Experience
These questions help us ensure mentors understand the context of our mentees’ lives.
Do you have experience working with BIPOC youth or underserved communities?
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If yes, please describe your involvement.
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Please share any lived experiences that may help you relate to mentees from economically disadvantaged backgrounds.
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What does cultural humility mean to you in a mentoring context?
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How would you handle conversations around race, trauma, or generational poverty?
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Mentee Preferences for Better Matching
Are there specific mentee interests, experiences, or goals you feel especially well-suited to support?
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Do you have any personal interests or hobbies you'd love to share with a mentee?
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Are there any mentee characteristics you feel less comfortable or less experienced supporting?
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Training and Support
What training or resources would help you feel more confident as a mentor?
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Are you open to attending virtual training sessions and reflective check-ins?
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Background & References
Please provide two references (Name, Relationship, Contact Information)
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Do you consent to a background check for the safety of the students?
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Have you ever been investigated or disciplined for inappropriate behavior involving youth?
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If yes, explain
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Agreements and Alignment
Why do you want to serve as a mentor with Tilled Soil? (Personal motivation and mission alignment)
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How do you see your values aligning with Tilled Soil’s mission of empowerment, equity, and legacy-building for young girls?
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Agreement to:
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Signature
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2/18/26
Mark this complete when finished.
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