Mentee Application

Save Our Youth will collect information about your child’s identity and ask your child to complete surveys in order to best serve your child and improve and evaluate our program. This information will not be shared with anyone outside the organization and is stored securely.

 

Please complete in one sitting as the form may not save your progress.

You must click SUBMIT at the bottom when done.

We collect this information below in order to recieve grant funding as a nonprofit. We do not share outside the organization. 

By signing below, I agree to the following:

• Youth: To meet my mentor on a weekly basis for a minimum of one year.
• Parent and Youth: To return my mentor's calls.
• Youth: That Save Our Youth will actively monitor my academic performance and expects me to attend and pass all my classes to the best of my ability
• To allow Save Our Youth to contact an adult (teacher, counselor, pastor, etc.) outside the family who knows my child well if necessary 

I understand that my signature on this form allows the Organization to use my child’s data for the purpose of evaluating programs and improving the Organization’s ability to meet my child’s needs.

I understand that my records are protected and that any information released pursuant to this consent remains subject to restrictions in applicable federal and state laws. 

I understand that my child’s participation in this program cannot be conditioned in any way upon my executing this Authorization.