• Student Enrollment Profile

    This has two sections. The first to be completed with the student. The second to be completed by the teacher or counselor.

  • Please interview the mentee and write in student responses to each stem.

  • The next section will require only teacher or counselor response

  • Possible 45-60 minute periods that student would be available for mentoring 1x/week:

  •  :
    TO
     :
  •  :
    TO
     :
  • Has this student been involved with law enforcement officials?*
  • If so, was it a result of his/her committing a crime?
  • Gang Affiliation
  •   
  • Should be Empty: