B.O.S.S. Mentoring, Inc. Mentee Pre-Application 2021-2022
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What Mentoring Year?
2021-2022 Mentoring Year
Child's Full Name
8 years old
9 years old
10 years old
11 years old
12 years old
13 years old
14 years old
15 years old
16 years old
17 years old
18 years old
Has your child been apart of B.O.S.S. Mentoring, Inc. in previous years?
What school does your child attend?........ What City?
Is your child receiving any other services? (ex. wraparound, in-home counseling, therapy)
What grade is your child in?
Do you think your child(ren) will benefit from a mentor?
Yes! Very much So!
Is there anything specific you think your child would benefit from?
Is your child receiveing any wraparound services (ex. counseling, thearpy, in-home counseling)
Will your child be able to attend sessions every Monday? (located in Camden, NJ)
Is your child involved in any activities that could stop them from attending sessions on Mondays?
Are both parents actively involved?
Mother & Father
Mother & Step-Father
Father & Step-Mother
Parent(s)/Guardian(s) Phone number
Will you be able to pay a $50 enrollment fee for the year?
Other Questions? Comments?
A copy of your responses will be emailed to the address you provided.
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