Coming of Age Mentor Selection Form

Mentor Selection Form

A commitment from a mentor should be secured by August 1, 2017.

* Indicates required field

Participant Name *

First

Last

Parent/Guardian Name *

First

Last

What are 5 adjectives that help describe participant? *

How would participant describe their social "style" (outgoing, reserved, high energy, intellectual, etc.)? *

What are current interests, in and out of school? *

What does participant think about the mentor part of COA? Have they thought of it? Are there any ideas about what they would like it to be like? Any directions for an adult talking to them about spirituality? *

Do you have a desired mentor candidate already? If yes: Have you been in contact? Is this person interested? *

Please list contact information for potential mentor if available. *

Other possible mentor names. Include any pertinent information, including relationship or possible questions. *

Submit