HUB Kids 4 - 9 Student Application for Mentoring

HUB Kids 4 - 9 Student Application for Mentoring

Please complete one form per child if you are interested in having them paired with an adult mentor.
All mentoring will take place at The HUB during HUB Kids hours. Mentors will not meet the child off premises nor exchange personal information (cell phone, social media, etc). All mentors have been background checked and will remain in a visible area at all times when meeting. Converstations will remain private unless a safety concern is involved.

Please ask questions! We aim to support and complement parents. We want you to feel comfortable, informed, and involved!
Student's Name*

First NameLast Name
What grade is your child in?*
How old is your child?*
What are the two most important things we should know about your child?*
Please explain any unusual family circumstances that make mentoring important for this child (i.e. recent crisis, economic hardship, severe neglect, being moved into foster placement etc.).*
Are there any behaviors you find yourself struggling with your child? (i.e. aggressiveness, biting, hyperactive, lying, runs away, tantrums etc.) If you list any, could you explain more?*
Signature*

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