Family Mentor Program Application- Regional Coach

Family Mentor Program Application- Regional Coach

With funding from the Ontario Trillium Foundation, Children’s Treatment Network (CTN) is excited to grow the current Family Resource Program to expand resources for families who have a child with autism. Regional Coaches will be an integral part of the training and management of the Volunteer Mentor team.

Name:

Contact Information:

E-mail:

Home Telephone Work Telephone

Home address

Street address, Town/City Postal Code

Tell us why you would like to be a Regional Coach for our Family Mentor Program.

Skills and Experience

The Family Mentor Program relies on individuals with demonstrated skills, experience and/or qualifications in a broad range of areas, who represent the diversity of the children and youth CTN serves, and the communities in York Region and Simcoe County.

Please check all the areas below where you have knowledge, skills or experience: that you think would benefit the Family Mentor Program:

Caregiver of a preschool child with autism

Caregiver of a school age child with autism

Caregiver of youth with autism

Caregiver of adult with autism

Receives or received services from CTN or a CTN Network Partner

Understanding of community services and resources for families who have children with autism

Experience as a CTN or partner volunteer (Role: )

Previous experience presenting to parents or professionals

Previous experience hosting and organizing information sessions in personal or professional setting

Created training materials (eg. manuals, e-learning modules, presentations, etc.)

Managed team of volunteers or a committee/group

Has been a mentor to another family

Experience in a training or management role

Committee or Board leadership (ie. Chair or Executive level)

Advocacy experience

Public Relations/Communications/Marketing

Online Research proficiency

Computer Competency (eg. Word, Excel, Powerpoint, Prezi, WebEx/Zoom Meeting software, plus social media networks)

Other

Please indicate what languages you speak other than English:

French

Chinese Languages

Italian

Russian

Farsi

Tamil

Punjabi

Spanish

Urdu

Other:

My current occupation is:

Brief Bio, Resume or Description of your life experience, and Reference

A copy of my current bio or resume is attached

I’m interested in:

Part Time Regional Coach in Simcoe (2 year contract)

Part Time Regional Coach in York Region (2 year contract)

Volunteer Mentor role (offering support and resources to another family with shared experiences)

Vulnerable Sector Screening:

Yes, I have received my Vulnerable Sector Screening (police check completed within the past 6 months) and am willing to share with CTN

No, I have not received my Vulnerable Sector Screening (police check) but I am willing to complete one upon request

Submission Information

Please submit this application form and your current bio or resume to:

Julia Sadler,

Phone:1-877-719-4795

Children’s Treatment Network 13175 Yonge St. Richmond Hill, ON L4E 0G6

Privacy Statement

The information collected by Children’s Treatment Network on this form is for the purpose of assessing candidates for the CTN Family Mentor and Volunteer Program. This information will not be used for any other purpose, or shared with others.

CTN – Family Mentor Program-Coach Recruitment Profile and Application (Revised January 2018) Page 1