MS Youth Challenge Academy
CL 61 Mentor Agreement
Dec 14, 2024 - Dec. 14, 2025
As your mentor, I agree to adhere to the following guidelines during our commitment to the MS Youth Challenge Academy.
Confidentiality Agreement:
Protect all IDENTIFIABLE DATA or Information on or about a Cadet including:
- Name of Cadet, Parent, Mentor or Other Family Member
- Address information
- Personal Identification Number (SSN)
- Indirect identifiers (date of birth, place of birth, mother's maiden name
- Any PHI information protected under HIPPA
Expectations
- Mutual Goals: To be in contact with each other and the Youth Challenge Academy every month for 12 months, beginning on graduation day, and send in a monthly report.
- Contact Requirement: One monthly recorded contact made between the cadet and mentor per the parameters in the program.
- Pledge of mutual respect:
As your mentor, I am committed to:
- supporting you
- being responsible
- being trustworthy
- being patient
- being positive
- being dedicated to your needs
- listening to you
- respecting your ideas
- helping you reach your goals and assisting you as you enter adulthood