Mentor Application

Through life and career skills, CJC offers men and women the opportunity to reach their full potential.

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Complete application form in its entirety. For questions please contact

If you prefer you may download and print the application form. Please email completed forms to or mail to:

Christian Job Corps
P.O. Box 525
Huntsville, AL 35804

Applicant Information

Applicant Name
Birth Date



Church Membership

Emergency Contact Information


Please list three personal references.

Tell Us About Yourself

Tell us about any church or community activities you are involved in.

Additional Information

Will you commit to attend a Mentor Training session?
Do you give your permission for a background check to be run on you?

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