Heart Connection Profile Card Please fill in all blanks that apply to you.
Birth date (month / day) City
Address Home Phone
Engaged Married (# yr.
Email Business Phone
) Blended Family Divorced (# yr
Spouse’s Name Children’s Ages (M)
Have attended VCC since I want to be a: Mentor Mentee Either Both I would like to be matched with: Hobbies, Interests, Gifts:
What I desire in a mentoring relationship is:
Is there anything in your life today that you feel would interfere with you being a mentor?
Is there anything in your life today that you feel would interfere with you being a mentee?
Please continue on the back of this card and share any personal or background information you feel would be helpful in making a mentoring match. Thank you and blessings!