Nanaimo Region John Howard Society 200-1585 Bowen Road V9S 1G4 Nanaimo, BC 250-754-1266 www.johnhowardnanaimo.org RESTORATIVE JUSTICE YOUTH MENTORING PROGRAM: VOLUNTEER MENTOR APPLICATION Name: Address: _ Telephone (Home): (Cell): Email: _ Occupation: Please briefly describe your employment history: Please briefly describe your educational history: How are you involved in your community? Why do you want to participate in the Mentoring Program? What do you believe young people need most to succeed? What are your hobbies and interests? How did you hear about the Mentorship Program? Do you have a valid BC Driver s License? Do you have access to a vehicle? 1
VOLUNTEER MENTOR AGREEMENT As a mentor, you are in a position of trust. It is extremely important that you understand the commitment you are making to the young person you are assigned to, their family, and to Nanaimo Region John Howard Society. If you are in doubt about any situation, the Program Coordinator should be contacted immediately. PHILOSOPHICAL EXPECTATIONS Recognize the unique characteristics and strengths of the young person. Organize activities in which the young person will experience success. Plan activities that will promote the physical, emotional, social and/or intellectual growth of the young person. Observe and assess the capabilities of the young person and use this knowledge in planning future activities. Be an adult friend, guide and positive role model in the young person s life always remembering that you are not an authoritarian figure or a counsellor. Accept the young person as is, and avoid making judgments, giving advice and moralizing. Model and reinforce socially acceptable behaviour and disregard, as much as possible, unacceptable behaviour. Remain neutral with respect to conflicts between adults in the young person s life. PRACTICAL EXPECTATIONS Have weekly contact with the young person; this means that you will text, phone, Skype, Tweet, Facebook etc. and keep the communication flowing with the young person. Continue supporting the youth for the full duration of his/her participation in the Restorative Justice Program. Attend the young person s intake interview, community justice forum, and exit interview. Ensure that all activities are safe, legal, socially acceptable, and age appropriate. Provide Monthly Reports and Activity Logs to the Program Coordinator (due the first week of the following month). Respond to the Program Coordinator within 48 hours of being contacted. Contact the Program Coordinator as soon as possible when a critical incident occurs. Protect the privacy of the young person by keeping all personal information confidential and only disclose such information when properly authorized to do so, or when obligated legally or professionally. Never use physical restraint, control, coercive power, threats, guilt or humiliation against the young person. Never engage in any activity with participants of any age or gender which is, or which could reasonably be perceived to be sexual, sexual leading, or sexually harassing, or otherwise personally intimate, including dating, whether or not such activity is desired or accepted by the participant. Never supply cigarettes, alcohol, or any other illegal substances to any participants. Never allow the young person to drive your car, or sit unattended in your car unless the keys have been removed. Never enter a vehicle in the youth s possession. Activities participated in by the youth and the mentor should be limited to the community and never in the dwelling house of the youth or the mentor. Never allow the young person to drive or ride on a motorcycle, or other two- or four-wheeled motorized vehicles, such as snowmobiles, ATV s, or jet-skis. Be alcohol and drug free for at least 10 hours before meeting with the young person. Take reasonable care and caution in observing all safety standards while volunteering. Ensure that any vehicle used to transport the young person is safe, in reliable condition and fully insured. 2
Inform the Program Coordinator in the event you are indicted or charged with an offence under the Criminal Code of Canada, as soon as possible. In order to maintain the position as a volunteer mentor, you must: Attend mentoring support meetings and educational sessions. Attend mandatory training sessions. Maintain regular contact with the Program Coordinator and the youth until the youth has completed his or her Community Justice Agreement and all relevant forms have been completed. Complete monthly reports and return them to the Program Coordinator on time. REPORTING RESPONSABILITIES As a volunteer mentor, you are required to provide the Mentorship Program Coordinator with monthly reports. The monthly reports are provided at the intake interview and can be supplied via email upon request. You can drop off the reports in person, or you can email them to the Program Coordinator (randi@johnhowardnanaimo.org). MONTHLY REPORTS Purpose of Monthly Reports: Provide an up-to-date record of the nature of the relationship between the volunteer and the youth for the RJ Program Coordinator. Provide a summary of the volunteer s work. Give some indication of the short and long term objectives in mind for each youth. Provide useful information for evaluation of the program as a whole. Give an indication where the youth is at with completing his/her Community Justice Agreement. I,, agree to and understand the expectations and responsibilities of volunteer mentors, as described above. 3
HARM AGREEMENT The Nanaimo Region John Howard Society requires all Volunteer Mentors to contact their Program Coordinator as soon as possible whenever they are concerned about their responsibility to protect the confidentiality of information. Your obligation to protect the confidentiality of information that the young person you are working with does not apply when disclosure is necessary to prevent harm to them or to other individuals. This includes situations when you suspect a young person is being harmed (physical or sexual abuse), they intend to harm themselves (suicide) or they are planning to harm others (physical violence). These are the three instances where you are required by law to disclose confidential information immediately to your Program Coordinator by calling The Nanaimo Region John Howard Society at 250-754-1266. If the incident occurs outside of office hours, the mentor must contact the Program Coordinator and immediately call: Vancouver Island Crisis Line at 1-888-494-3888 if the young person discloses that they have harmed themselves, are planning to harm themselves and/or commit suicide, or are having suicidal thoughts. The police at 911 if the young person discloses that they are planning to harm another person. Ministry of Children and Family Development at 250-741-5444 if you suspect that, or the young person discloses that, they are being harmed physically or sexually by a family member. 4
MEDIA-PUBLISHING CONSENT AND RELEASE This form is to give consent to interview, videotape and photograph and publish stories for funding and/or purposes of The Nanaimo Region John Howard Society (NRJHS). This consent extends to NRJHS sponsored programs and partnership initiatives. I, (please print) give permission to NRJHS to use the following personal information in NRJHS promotional materials, programs, newsletter, electronic and printed materials including posters, brochures, news articles reports, and web sites, without payment of any fee or consideration of me. I agree that NRJHS owns copyright in these photographs and I waive any claims I may have based on the usage of the photographs. The NRJHS may (please circle yes or no) Interview me for public relations purposes yes no Use quotes from my interviews yes no Take photographs of me yes no Take videos of me yes no Use my full name yes no Use my first name only yes no ~OR~ I,, do not agree to JHS using my information for funding and/or public relations purposes. Volunteer mentors are required to supply the following to the Program Coordinator before being matched with a youth: 1. Copy of valid driver s license 2. Copy of valid car insurance 3. Driver s abstract Note: Please ensure that you have completed all general volunteer application paperwork (located on our website: www.johnhowardnanaimo.org) and submitted it to our Volunteer Coordinator, Cheryl Dodge. Thank you for your interest in the Restorative Justice Youth Mentoring Program! 5