Enrol a Young Person

CHILD INQUIRY FORM

To receive more information about our mentoring programs and how to register your child please complete the form below and our Intake Coordinator will give you a call to discuss the application process.

Parent/Guardian Information
Parent/Guardian Name*
First Last
Email*
City*
What is the best phone number to reach you at?*
CHILD INFORMATION
Child/Youth's Name*
First Last
Child/Youth’s Age:*
Child/Youth Date of Birth*
DD slash MM slash YYYY
Child/Youth's Gender*
One-to-One Mentoring Program(s) of Interest
- One-to-One Big/Little Mentoring
- Virtual Mentoring Program (ages 6-14)
Select any programs in which you believe suits your child best. For more information on programs visit the "Our Programs" tab under MENTORING PROGRAMS.
Group Mentoring Program(s) of Interest
- Power Play Functional Mind and Body (ages 10-15)
- Power Play Yoga (ages 10-15)
- Go Girls (females ages 11-14)
- Switch Gears 2.0 (males ages 10-14)
- The Little Studio (ages 9-14)
Select any programs in which you believe suits your child best. For more information on programs visit the "Our Programs" tab under MENTORING PROGRAMS.
Where did you hear about us?*
Phone
This field is for validation purposes and should be left unchanged.

CRITERIA

HOW IT WORKS

When applying for our programs, a mentee must be between the ages of 6 and 16 years. The mentoring relationship can be supported by the agency through to 18 years of age.

An Intake Coordinator will work with you and your child to review your situation and determine how a mentor would be of benefit. Factors that would be considered regarding your child’s needs include:

Parent or guardian support
Adult involvement other than the parent(s) or guardian(s)
Peer relationships
School performance
Involvement in community activity
Living environment
Ability to form and maintain a healthy, safe relationship
Ability to perform self-care

Enrol a Young Person

CHILD INQUIRY FORM

Parent/Guardian Information

CHILD INFORMATION

CRITERIA

HOW IT WORKS