Black Kids in Action (BKIA) Mentorship Application Form

Thank you for your interest in becoming a member of Black Kids in Action (BKIA). Please complete the form below. All information provided will be kept confidential and used solely for membership purposes.

Personal Information

Full Name

Date of Birth (YYYY/MM/DD)

Year

Month

Day

Gender

Male

Female

Other

Prefer not to say

Phone Number

Email Address

Home Address

Country/Region

Address

City

Zip / Postal code

Volunteer Interests & Skills

Why do you want to mentor with BKIA?

Thank you for your interest in becoming a member of Black Kids in Action (BKIA). Please complete the form below. All information provided will be kept confidential and used solely for membership purposes.

Availability & Commitment

How much time can you commit as a volunteer?

Weekly (5+ hours)

Monthly (1-4 hours)

Occasionally (Special events/projects)

Are you willing to attend BKIA meetings and training sessions?

Yes

No

Are you comfortable working in diverse team settings?

Yes

No

Additional Information

Do you have any skills, certifications, or experiences that could contribute to BKIA’s mission?

Would you be interested in leadership roles within BKIA?

Yes

No

Declaration & Consent

I confirm that all the information provided is accurate to the best of my knowledge. By submitting this application, I agree to abide by the rules and values of Black Kids in Action (BKIA). I also consent to being contacted regarding membership activities and opportunities

1168 Drouillard Road Unit 1, Windsor, Ontario

519-254-5155

info@bkia.ca

Inspire and guide the next generation of leaders.

By volunteering as a mentor, you’ll empower Black youths with the skills, advice, and encouragement they need to crush their goals.

Ways to mentor:

Skills Coaching: Share your expertise in creative arts, STEM, business, or leadership.

Project Support: Help youth plan, budget, and deliver impactful community projects.