Life Support - Youth Referral Form for SC
Mentoring Youth in Foster Care, Ages 12-21

Many youth in foster care want a caring adult to walk beside them during the trials and uncertainty of life in care. Our mentors commit to seeing their ‘mentee’ twice each month and staying involved as long as the youth remains in care, and beyond. Referrals can come from any child advocate, but must be approved by social services before services begin.
Your Name *
Your Email *
Youth Referral Information
Youth First Name *
Youth Last Name *
Youth Date of Birth *
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Youth Race *
Youth Grade *
What are the youth's interests? What does he/she like to do? *
What are some of the youth's personality traits? How would you describe him/her to a stranger? *
Is there any family involvement? If so, who and how often? Does the youth see siblings? *
Does the youth have any prior charges or concerns that a mentor should be aware of? *
Is there anything else you would like to share to help us make a match (detail is good)?
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