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Get mentored

 For I know the plans I have for you,” says the Lord. “They are plans for good and not for disaster,

to give you a future and a hope. - Jeremiah 29:11

Birthday
Month
Day
Year
Gender

PARENT INFORMATION:

Do you or your family receive any of the following?

HEALTH INFORMATION & BACKGROUND

Please identify and explain any of the following which apply

List all specialized services you or your child receive:

I Am Whole Focus Domains: Mentee/Mentor Concentrations

  • Education

  • Emotional

  • Financial

  • Physical

  • Social

  • Spiritual

What days of the week are you available to participate? (check all that apply):
What is the best time for you to participate? (check all that apply):

Adapted from materials provided by Mentoring Partnership of Long Island, The ABC’s of Mentoring, and California Governor’s Mentoring Partnership.

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