Pittsburgh



516001018669000-54800517526000 mentor2.0Volunteer Form City of Pittsburgh EmployeesNew volunteers will typically mentor a 9th grade student who attends Brashear High School (Beechview). Weekly 30-minute sessions occur over a secure curriculum-based online platform. Mentor2.0 in-person meetings take place once a month on a Tuesday from 5:00-7:00pm at Brashear High School. See page two (2) for the specific in-person program dates which will depend on whether your mentee is in 9th, 10th, 11th or 12th grade. Name: Home Address: Department: Title: Cell Phone: Secondary Phone: I am a: New Mentor ? Returning Mentor ? If you are a new mentor, you must apply online at the “Start a New Mentor Application” tab.Clearances: PA Act 33 (PA State Police), PA Child Abuse, and FBI Clearances are required for all volunteers. Have you received any of those clearances within the past year? YES ? NO ?If Yes, please provide copies during the application process. If No, your program coordinator will provide information on how to obtain these clearances. Program Parameters:City employees must have approval in order to serve as a mentor during regular work hours. Forms that do not have the signatures required below will be deemed incomplete and returned.Per the Mayor’s Executive Order and with supervisory approval, you may receive paid administrative leave for up to four (4) hours per month: 30 minutes per week for online interaction and up to two (2) hours for monthly face-to-face meeting(s) and related travel that occur during regular working hours.__________________Supervisor (print name)SignatureDate__________________Director/Bureau Chief (print name)SignatureDateContact mentorpgh@ or call (412) 255-2712 with any questions.Please return all forms attention: Mayor’s Mentoring Initiative (MMI):via email: mentorpgh@via interoffice mail to: Human Resources & Civil Servicevia fax to: (412) 255-2425via regular mail to: 431 City County Building , 414 Grant Street, Pittsburgh PA 15219Mentor 2.0 2019 - 2020 In – Person Events Brashear High School-590 Crane Ave. Pgh, PA 152165:00-6:45 PM9th Grade:10/29 - Kick off Night 11/2612/17 - Winter Celebration 1/212/183/244/215/26- End of Year Celebration 10th Grade:8/27- Mandatory Training 10/15 - Kick off Night 11/1912/10 - Winter Celebration 1/142/113/104/145/5 - End of Year Celebration 11th/12th Grades:8/27- 12th Grade MANDATORY TRAINING9/10-11th Grade MANDATORY TRAINING 10/8 - Kick off Night 11/1212/3 - Winter Celebration 1/72/43/33/315/12 - 12th Grade Graduation5/19 - 11th Grade End of Year Celebration ................
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