Dream Bigger Mentoring Program Enrollment Form (2022-23)
By completing this form you are authorizing your student to participate in the Coalition of Black Men's mentoring program: Dream Bigger offered within Portland Public Schools for the 2022-2023 school year.

As a Parent / Guardian / Surrogate Parent / Foster Parent / or Adult Student, I authorize the release and exchange of confidential information between Portland Public Schools, Coalition of Black Men and their evaluators.

This information may include:
     Student name & student ID#
     Demographic information (such as race, gender, grade)
     Discipline data

The disclosure is to be used for the following purposes:
     To support students' educational needs
     To support students' school attendance
     Program evaluation

We have a capacity of 15 students per school:

Astor Elementary School: 7 openings
Faubion School: Waitlist Available (5)
Harriet Tubman Middle School: Waitlist Available (3)
Ockley Green Middle School: 3 openings

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