BCYMP Mentee Application 

Parents and Guardians:

Please fill out this application to request a BCYMP Mentor for your child. We will then add your child to the "Pending Mentee" list and begin the process of finding the best volunteer Mentor for him or her. Please understand that sometimes it takes several months for the best BCYMP Mentor for your child to apply, finish training and be ready to match. We will update you about every 3 months that your child is waiting, and you are always welcome to call or email us to inquire about the status of your application, too. The more information you give BCYMP, the better able we will be to find a great Mentor, so we may call you if we need more information.  Thank you.

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* 1. Today's Date

Date / Time

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* 2. Child's Full name

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* 3. Birthdate

Date / Time

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* 4. Child's Gender

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* 5. Child's Grade in School for 2019-20 year.

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* 6. Child's School

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* 7. Parent/Guardian's Name and Contact Information

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* 8. Secondary Household Name and Contact Information (Skip if not relevant)

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* 9. Child's Interests (Please be thorough.)

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* 10. Does your child attend Boys and Girls Club, G.A.P. or participate in after-school activities? Please list.

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* 11. May BCYMP text you?

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* 12. If you answered yes to #11, what phone carrier do you use?

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* 13. Is there anything else you'd like BCYMP to know about your child that would help us find a good Mentor for him or her?

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