Buddy/Mentor Application

- Helping Others

Buddies play a pivotal role in welcoming all God’s children. A Buddy is an adult or a high school student who provides support to a child with special needs so that they can successfully be included in religious formation. Our goal is for every child to participate in faith formation, to engage with their peers, and to feel a sense of belonging. Can you make a difference to a child? Are you ready to have an impact? No experience is necessary – if you are able to serve, we are able to provide you with training and support.
Embracing Special Needs
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- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Address REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Birthday (MM-DD-YYYY) REQUIRED Please fill out this field. Please enter valid data.
- How long have you attended St. Laurence? Please enter valid data.
- Please describe any previous volunteer or professional experience that may benefit you as a Buddy.
- Have you taken Jeremiah (8th grade-age 17) or Safe Haven (Virtus) (18 years and older) safe environment training? REQUIRED Yes I have taken Jeremiah Yes I have taken the Safe Haven or Virtus Training No I have not received training Please fill out this field.
- Date of Training REQUIRED Please fill out this field. Please enter a date.
- Please select which age group you enjoy working with the most or the time that meets your schedule: REQUIRED Please fill out this field.
- Please provide a reference (other than a family member)
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Address REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Emergency Contact Information
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Phone Number Maximum 20 characters Please enter a phone number.
- Email Please enter an email address.
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Contact Us
- Embracing Special Needs
  
  281-265-5774
  disabilitiesministrystlaurence.org