Pittsburgh



51149257620000-6667507620000Be A Middle School Mentor Volunteer FormCity of Pittsburgh EmployeesName: FORMTEXT ?????Home Address: FORMTEXT ?????Department: FORMTEXT ?????Title: FORMTEXT ?????Cell Phone: FORMTEXT ????? Secondary Phone: FORMTEXT ?????I am a: New Mentor ? Returning Mentor ? 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 to your BAMSM program coordinator. If No, your BAMSM program coordinator will provide information on how to obtain these clearances. You will be reimbursed for the cost of clearances if you provide a receipt.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.It is your responsibility to notify your supervisor of the day and time of your program once your school site has been finalized. See page two for a list of schools/days/times.Per the Mayor’s Executive Order and with supervisory approval, you may receive paid administrative leave for up to two (2) hours per week for mentor programs and related travel that occur during regular working hours.__________________________________________________________________________Supervisor (print name)SignatureDate__________________________________________________________________________Director/Bureau Chief (print name)SignatureDateIf you are a new mentor, you must register online at . Click the RED VOLUNTEER button to get started. During the online registration process, you will be required to select a school site/day/time and orientation training session from a dropdown menu.Difficulty with registering or have questions? Please contact Kathy Rodriguez, BAMSM Mentor Recruiter at Kathy.rodriguez@ or (412) 456-6822.PITTSBURGH PUBLIC SCHOOLS (NEIGHBORHOOD)ADDRESSMENTORING DAY/TIMESMENTORING AGENCYPittsburgh Allegheny(North Side)810 Arch St. Pittsburgh, PA 15212Tuesdays 12:50-1:30pm; 4:00-4:50pmCommunities in SchoolsPittsburgh Arsenal(Lawrenceville)220 40th St.Pittsburgh, PA 15201 Tuesdays 11:58-12:38pmBig Brothers Big SistersPittsburgh Classical(West End)1400 Crucible St. Pittsburgh, PA 15205Thursdays 3:50-5:00pmBig Brothers Big SistersPittsburgh Colfax(Squirrel Hill)2332 Beechwood Blvd.Pittsburgh, PA 15215Tuesdays 3:00-4:30pmMt. Ararat Community and Activity CenterPittsburgh King(North Side)50 Montgomery PlacePittsburgh, PA 15212Wednesdays 12:35-1:20pmCommunities in SchoolsPittsburgh Manchester(North Side)1612 Manhattan St. Pittsburgh, PA 15233Fridays 12:30-1:15pmCommunities in SchoolsPittsburgh Milliones/U Prep(Hill District)3117 Centre Ave.Pittsburgh, PA 15219Tuesdays12:20-1:10pmUrban League of Greater PittsburghManchester Academic Charter (North Side)One Heinz St. Pittsburgh, PA 15212Thursdays 11:30-12:15pmCommunities in SchoolsPittsburgh Morrow(North Side)3530 Fleming Ave.Pittsburgh, PA 15212Mondays 11:45-12:30pmCommunities in SchoolsPittsburgh Obama(East Liberty)515 N. Highland Ave.Pittsburgh, PA 15206Fridays 11:38-12:20pm; 12:23-1:05pmMt. Ararat Community and Activity CenterPittsburgh Schiller (North Side – Troy Hill)1018 Peralta St.Pittsburgh, PA 15212Wed. 11:00-11:48am; 11:51-12:39pmBig Brothers Big SistersPittsburgh Sci-Tech(Oakland)107 Thackeray Ave.Pittsburgh, PA 15260Mondays 10:25-11:15amBig Brothers Big SistersPittsburgh South Brook(Brookline)779 Dunster St.Pittsburgh, PA 15226Mondays 3:50-5:10pmBig Brothers Big SistersPittsburgh Sterrett(Point Breeze)7100 Reynolds St.Pittsburgh, PA 15208Wednesdays 3:50-4:50pmMt. Ararat Community and Activity CenterPittsburgh Sterrett(Point Breeze)7100 Reynolds St.Pittsburgh, PA 15208Tuesdays/Thursdays6:00-7:00pmHigher AchievementPittsburgh Westinghouse(Homewood)1101 N. Murtland St.Pittsburgh, PA 15208Thursdays 12:20-1:10pmUrban League of Greater PittsburghContact 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 15219 ................
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