BEHIND EVERY DOOR MINISTRIES
Mentor Application
2824 Swiss Avenue
Dallas, Texas 75204 | 972.331.4774
Behind Every Door Ministries Use Only:
Date Application Received
Property
Background Check Date
Status
Application Reviewed By
Matched Y 
N 
Cleared  Pending 
Expired 
Rejected 
Approved By
Date
Mentee Name
PRINT IN BLACK INK OR TYPE. These instructions must be followed exactly. Fill out application form completely. If questions are not
applicable, enter "NA." Do not leave questions blank. Be sure to sign when completed. Behind Every Door Ministries does not
discriminate on the basis of race, color, national origin, sex, religion, age or disability in employment or the provision of services.
Resumes will not be accepted in lieu of applications. This application becomes public record and is subject to disclosure.
APPLICANT INFORMATION
Last Name
First
M.I.
Street Address
Date
Apartment/Unit #
City
State
ZIP
Cell Phone
E-mail Address
List any other names used if different from name on this application.
Date of Birth
Social Security No.
Driver’s License # and State
Marital Status:
Single 
Married 
Name(s), Age, Gender of Children
Are you a citizen of the United States?
YES
NO
In Case of
Emergency
If no, are you authorized to work in the U.S.?
Relationship
YES
NO
Phone
EDUCATION
High School
From
Address
To
Did you
graduate?
College
From
NO
Degree
NO
Degree
NO
Degree
Address
To
Did you
graduate?
Other
From
YES
YES
Address
To
Did you
graduate?
YES
SKILLS / CERTIFICATES
If a license, certificate, or other authorization is required or related to the position for which you are applying, complete the following:
LICENSE/CERTIFICATION
(P.E., R.N., Attorney, C.P.A., etc.)
Date issued
Date expires
Issued by/Location of issuing authority
(State or other authority) (City & State)
License No.
Special Training/Skills/Qualifications: List all job related training or skills you possess and machines or office equipment you can use, such
as calculators, printing or graphics equipment, computer equipment, types of software and hardware. (Attach additional page, if necessary.)
Do you speak a language other than English? Yes

No 
If yes, what language(s)?
CRIMINAL / DRIVING RECORD
Have you ever been convicted of a felony or subjected to deferred adjudication on a felony charge for any crime, including sexual
misconduct, child abuse, offenses against persons or family, or public indecency? YES 
NO 
Has your driver’s license ever been suspended or revoked? YES 
NO 
If you answered “YES” too either question, explain in concise detail on a separate page, giving dates and nature of the offense, name and
location of the court, and disposition of the case(s). A conviction may not disqualify you, but a false statement will.
Do you have full-coverage automobile insurance?
YES 
NO 
CURRENT EMPLOYER
Company
Phone
Address
Supervisor
(
)
(
)
(
)
Responsibilities
From
To
Reason for Leaving
May we contact your previous supervisor for a reference?
YES
NO
PREVIOUS VOLUNTEER & WORK REFERENCES
Company
Phone
Address
Supervisor
Responsibilities
From
To
Reason for Leaving
May we contact your previous supervisor for a reference?
YES
NO
Company
Phone
Address
Supervisor
Responsibilities
From
To
Reason for Leaving
May we contact your previous supervisor for a reference?
YES
NO
Company
Phone
Address
Supervisor
(
)
Responsibilities
From
To
From
May we contact your previous supervisor for a reference?
YES
NO
For Official Use:
Date Volunteer/Work References Verified: _________________________
Person Verifying References Signature:____________________________
PASTORAL / ELDER REFERENCE
Name
Relationship
Email
Years Known
Organization
Phone
(
)
Address
For Official Use:
Date Pastoral/Elder Reference Verified:__________________
Person verifying reference: Signature:____________________________________________________
STATEMENT OF FAITH
Current Church Attending
How Long
Please provide a brief summary of your spiritual journey. If you have come to a place of personal faith in Jesus Christ, briefly tell us about it:
Briefly describe how you are currently growing in your knowledge and love of the Lord:
VOLUNTEER QUESTIONARIE
Why do you want to volunteer with Behind Every Door Ministries?
What contribution do you feel you can make?
What do you hope to gain from this experience?
What do you feel is the greatest asset with working with children?
What are your personal interests and hobbies?
Although we cannot promise accommodation,
What gender would you like to mentee: BOY 
What age would you like to mentor: ELEMENTARY 
GIRL 
MIDDLE SCHOOL 
HIGH SCHOOL 
DISCLAIMER AND SIGNATURE
PLEASE READ THE FOLLOWING STATEMENT CAREFULLY BEFORE SIGNING:
I certify that my answers are true and complete to the best of my knowledge.
If this application leads to my acceptance as a Mentor, I understand that false or misleading information in my application or interview may
result in my release.
I understand that Behind Every Door Ministries will conduct a criminal background check prior to and during my service, as well as a child
abuse registry check and I am subject to random, accident follow-up, and for cause drug testing, as well as post offer drug screening contingent
on acceptance as a Mentor.
Furthermore, I certify that I do not abuse addictive substances, such as drugs or alcohol, and I will not use drugs or alcohol in any way that may
cause harm to any child in my care.
I agree to strive to honor God through scripture-based teaching and conduct in the performance of any services on behalf of the Ministry and in
my life. I understand that throughout my time volunteering with Behind Every Door Ministries I will be held accountable through monthly phone
or email conversations with Behind Every Door Mentor Coordinators and/or other staff.
Printed Legal Name
Signature
Date
Upon completion, please attach a copy of your driver’s license/proof of automobile
insurance and hand-deliver or return to Human Resources via:
Mail: Behind Every Door Ministries, Inc.
2824 Swiss Avenue
Dallas, Texas 75204
Fax:
972.331.4773
Email: [email protected]