B.O.S.S. Mentoring, Inc. Mentee Pre-Application 2022-2023
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What Mentoring Year? *
Child's Full Name *
Child's Age: *
What City/Town do you live in? *
What school does your child attend? *
What grade is your child in? *
Has your child been apart of B.O.S.S. Mentoring, Inc. in previous years? *
Do you think your child(ren) will benefit from a mentor? *
Not really
Yes! Very much So!
Is there anything specific you think your child would benefit from? *
Is your child currently receiving any wraparound services (ex. Perform Care, counseling, therapy, in-home/community support)? *
Will your child be able to attend in-person sessions every week? (located in Camden, NJ) *
Is your child involved in any activities that could stop them from attending sessions? *
Who is the primary caregiver for this child? *
Parent(s)/Guardian(s) Name *
Parent(s)/Guardian(s)  Phone number *
What is your email address? *
There is a non refundable enrollment fee for the year (Summer not included). Will you be able to pay that? *
How did you learn about BOSS Mentoring? *
Other Questions? Comments?
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