Go Local FXBG — Mentor Contact Form

Youth Internship & Career Pathways Program
Supporting high school interns with flexible, structured mentorship

Section 1: Contact Information

First Name *

Last Name *

Phone *

Email *

Company/Organization Name

LinkedIn/Portfolio URL

City/County *

Section 2: Professional Background

Current Role/Title *

Industry *

Years of Professional Experience *

Section 3: Areas of Expertise (Career Pathways Alignment)

Skills & Expertise: (Match to program tracks) *

Project Management & Operations

Administrative & Office Support

Project Review – feedback on student work

Web Design & Brand Experience

CRM & Systems

Community Outreach & Engagement

Video Editing & Media Production

Social Media Marketing & Content Creation

AI & Emerging Technology

Experience with Youth / Mentoring *

I have prior mentoring experience

I have experience teaching/training youth

I’m new to mentorship but eager to contribute

How You'd Like to Participate

Mentorship Interests *

Guest Workshop – lead a focused 30–60 min session

Mentor Q&A Session – structured conversation with students

Project Review – (Asynchronous Feedback)

Semester Mentor – periodic check-ins throughout the internship cycle

Open to discussing best fit

Preferred Format *

Virtual

In-Person

Either

Typical Availability: *

Weekday afternoons

Weekday evenings

Flexible / As scheduled

Estimated Availability Per Month *

Go Local FXBG prioritizes youth safety, professional boundaries, and ethical conduct. Mentors must comply with our Conflict of Interest and Whistleblower Policies.

Have you ever been convicted of a felony? *

Are you willing to complete a background screening if required? *

Are you willing to follow all youth safety guidelines and communication protocols? *

Program Acknowledgment *

I understand this is a structured educational program aligned with school Work-Based Learning standards.

Student Acknowledgment *

I understand students are not employees and will not perform job duties for my business.

Professionalism Commitment *

I agree to communicate professionally and uphold a positive mentorship environment.

Agreement & Next Steps

By submitting this form, you agree to: Support students in a structured, educational capacity aligned with the program goals. Participate respectfully, professionally, and with clear communication. Be contacted by the Go Local FXBG team to confirm your preferred involvement, scheduling, and track match.