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Prospective Deaf Mentor / Parent Advisor Interest Form

Please complete the form below. Required fields marked with an asterisk *

Questions? Please contact Briella Diaz at @[email protected].

First Name*

Answer required for "First Name"

Last Name*

Answer required for "Last Name"

Email*

Answer required for "Email"

City*

Answer required for "City"

County*

Answer required for "County"

Please indicate which role(s) you are interested in:*

Answer required for "Please indicate which role(s) you are interested in:"

Deaf Mentor

Parent Advisor

Have you had SKI*HI training?*

Answer required for "Have you had SKI*HI training?"

Yes

In-process

Thank you for your interest in becoming a Deaf Mentor! You will be contacted soon with additional information on if positions are available and how to start the application process.

Confirmation Email

Confirmation Email *

Answer required for "Confirmation Email"