Please fill out the form below:

TALKS Experience: *
Name *
Name
Phone *
Phone
Mailing Address *
Mailing Address
What best describes you: *
(150 words or less)
Which time slot(s) work best for your schedule? *
These are the available time slots set by the school for Monday-Friday.
Loyalty Oath *
By submitting this application, I solemnly affirm that I will abide by the policies and expectations of the TALKS Mentoring Program and Jackson Public Schools; that I will strive to be a positive role model and commit approximately 1 hour per week to my assigned mentees (with the exception of illnesses, emergencies, traveling, holidays, and unforeseen incidents); and that I have truthfully completed this application.
Common Ground Covenant Church (CGCC) Release & Waiver of Liability *
By submitting this application, I understand that this is a volunteer, unpaid position. I, the volunteer, release, and forever discharge, and hold harmless CGCC and its representatives and successors from any and all liability, claims, and demands of any kind or nature, either in law or in equity, which arises or may hereafter arise from my volunteer work for CGCC. I hereby release and forever discharge CGCC from any claim whatsoever which arises or may hereafter arise on account of any first-aid treatment or other medical services rendered in connection with an emergency during my time with CGCC. I grant and convey unto CGCC right title and interest in any and all photographic images and video or audio recordings made by CGCC during my participation at CGCC, including, but not limited to, proceeds or other benefits derived from any photographs or recordings made while participating in any CGCC event. I understand that any images and recordings taken by CGCC may be posted online. I agree that this release is intended to be as broad and inclusive as permitted by the laws of the State of Mississippi in the United States of America, and that this release shall be governed by and interpreted in accordance with the laws of the State of Mississippi.