Does Your Child Need a Mentor?

Is your child in need of extra support that a caring adult can provide?

Does your child need a boost in self-esteem?
Does your child need another trusting and caring adult in their life?

The Mentor does not replace parents/guardians or their role or authority in a child's life.

The Mentor is a special, supportive person in their lives. Studies have shown that many parents experience an improved relationship with their children because they

were given a mentor.

We ask mentors for a one-year commitment, minimum.
All mentors go through extensive background checks and training before they are matched

If you would like to ENROLL YOUR CHILD, please fill out the form below and click SUBMIT

Apply here

Child's first name

Child's last name

Parent / Guardian's full name

Your relationship to the child

Phone #

Parent / Guardian Email

Home Address

City, State, Zip Code

Child's Birthday

Month

Day

Year

What school does your child attend?

What grade is your child in?

What mentoring program are you interested in for your child?

Community Mentor - CM meets with a Mentee at least 2x a month

Lunch Buddy Mentor - LB has lunch at the Mentee's school 2x a month on set dates

Need more information on CM and LB programs

How did you hear about us?

Friend / Reference

Marketing / Flyer

Social Media

At an event

Describe your child's personality. Are they happy, active, caring, funny, quiet, smart, talkative, shy, angry, sad, or aggressive? etc.

What things are difficult for your child?

Does your child have challenges at school?

What other support services does your child receive through school and/or Columbia County?

Would you allow Kinship and/or the Mentor to communicate with the other support services? YES or NO

List any clubs, sports, activities your child is involved in.

List your child's favorite hobbies and activities - examples = sports, outdoors, board games, puzzles, arts and crafts, drawing, cooking/baking, fishing,

What would you like your child to gain, improve, or benefit from having a mentor?

Please list any FOOD allergies (reactions or aversions) and/or any PET allergies or issues your child may have.

Any specific diet and food restrictions or preferences?

How many siblings live with your child?

Do you give Kinship permission to use the child's photo? YES or NO

NAME of your child's Emergency Contact Person

What is their relationship to your child? neighbor, aunt, uncle, grandparent, etc.

PHONE NUMBER of your child's Emergency Contact Person

Child's Physician Name

Physician's Phone #

Preferred Hospital in case of emergency

How Can Kids Benefit From a Mentor?

Mentoring can improve kids’ lives by bolstering their self-esteem and offering opportunities for social and emotional skill development. We match children ages 5-16 with positive adult influences.

The Need

Refer a Child

Do you know a child who could benefit from the extra support of a caring adult?

Do you know a child who could use the extra boost of self-esteem?
Do you know a child who could use support in building social skills?
Do you know of a child who could use the benefits of opportunities of experiencing positive activities?

If you know of a child who could benefit from a Mentor, please fill out the form and click SUBMIT