Step 1 of 9

  • Child Application

    This application will take approximately 30 minutes to complete, it allows the agency to have a strong understanding of you and your child prior to interviews and matching in a mentoring program. Please fill out to the best of your ability and staff will contact you within 2 business days of receiving your application. All information remains confidential until a caseworker discusses what may be disclosed to a mentor with your approval.
  • Parent/Guardian Information

  • This cannot be the parent/guardian. The agency will make every effort to connect with parent/guardian, this will be in case we are unable to contact you.
  • How is this person known to your child?

  • MM slash DD slash YYYY



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.

A Mentoring 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