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Mentor Selection Form
A commitment from a mentor should be secured by September 1, 2020.
Please complete and submit this form whether you have contacted and procured a mentor, or if you seek guidance and assistance from staff. If you indicate that you have identified a mentor we will contact them with schedule and information; if you request help you will be contacted promptly.
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Indicates required field
Participant Name
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First
Last
Parent/Guardian Name
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First
Last
What are 5 adjectives that help describe participant?
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How would participant describe their social "style" (outgoing, reserved, high energy, intellectual, etc.)?
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What are current interests, in and out of school?
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What does participant think about the mentor part of COA? Have they thought of it? Are there any ideas about what they would like it to be like? Any directions for an adult talking to them about spirituality?
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Do you have a desired mentor candidate already? If yes: Have you been in contact? Is this person interested?
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Please list contact information for potential mentor if available.
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Other possible mentor names. Include any pertinent information, including relationship or possible questions.
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Submit