Mentorship Enrollment

We are honored you've chosen to begin the journey with us. This form helps us learn more about you and your child so we can make the best possible match with a caring mentor.

Your Privacy & Security

This is a secure form, and your responses will be shared only with you, our service provider, and us. subject to The Universe Terms of Service and Privacy Policy. We take your privacy seriously, however, no online system can ever be guaranteed completely secure. If you prefer, you may complete this application in person.

Before You Arrive

Before dropping off your child, please bring a valid photo ID. If applicable, proof of guardianship will also be required. At that time, you will review and sign a printed version of this form, pre-filled with the information you provide today.

Saving Your Progress

This form saves your progress on your device so you can return later if needed but you must submit it in order for us to receive your information. If you clear your cookies or wait more than 30 days, your information will be erased and you'll need to start again.

How to Navigate

Use the buttons at the bottom of each screen to move through the steps. Take your time and review important information before submitting.

Need Help?

If you run into any issues or have questions, our team is ready to help. Please reach out anytime — we'll be glad to assist you.

We're grateful for your trust and look forward to supporting your family.

Your Information

Information about you, the parent or legal gaurdian, filling out this form.

{"title":"First Name","name":"firstname","placeholder":"Jonathan","required":"true","icon":"bi-file-person","minlength":"3","maxlength":"128","type":"text","namespace":"ua.input"}

{"title":"Last Name","name":"lastname","placeholder":"Avery Karros","required":"true","icon":"bi-file-person","minlength":"3","maxlength":"128","type":"text","namespace":"ua.input"}

{"title":"Your Street Address","name":"street_address","required":"true","namespace":"ua.address"}{"title":"What's your email address?","icon":"bi-envelope","name":"email","required":"true","autocomplete":"email","placeholder":"yougotmail@example.com","type":"email","namespace":"ua.input"}{"title":"Main Phone","name":"phone","required":"true","namespace":"ua.phone"}{"title":"","name":"phone_type","required":"true","inner":[{"title":"Cell Phone","value":"cell"},{"title":"Home Phone","value":"Home"}],"namespace":"ua.select.group"}{"title":"Secondary Phone","name":"secondary_phone","namespace":"ua.phone"}{"title":"","name":"secondary_phone_type","inner":[{"title":"Cell Phone","value":"cell"},{"title":"Home Phone","value":"Home"}],"namespace":"ua.select.group"}

Youth Details

Information about the youth you are enrolling in the mentoring program.

{"title":"Youth First Name","name":"youth_firstname","placeholder":"Jonathan","required":"true","icon":"bi-file-person","minlength":"3","maxlength":"128","type":"text","namespace":"ua.input"}

{"title":"Youth Last Name","name":"youth_lastname","placeholder":"Avery Karros","required":"true","icon":"bi-file-person","minlength":"3","maxlength":"128","type":"text","namespace":"ua.input"}

{"title":"What's your Relationship to the Youth?","name":"relationship_to_youth","required":"true","inner":[{"title":"Mother","value":"mother"},{"title":"Father","value":"father"},{"title":"Grandparent","value":"grandparent"},{"title":"Sibling","value":"sibling"},{"title":"Guardian","value":"guardian"},{"title":"Social Worker","value":"socialworker"},{"title":"Other","value":"other"}],"namespace":"ua.select.group"}{"title":"If other please specify","name":"other_relationship","placeholder":"","icon":"bi-pencil-square","namespace":"ua.input"}

{"title":"Date of Birth","name":"dob","required":"true","namespace":"ua.select.date"}{"title":"Gender","name":"gender","required":"true","inner":[{"title":"Male","value":"male"},{"title":"Female","value":"female"}],"namespace":"ua.select.group"}

If your child will be in the work force program, you'll be asked to provide their Social Security Number in person. For security reasons, we don't collect SSNs online.

{"title":"Ethnicity","name":"ethnicity","required":"true","inner":[{"title":"White","value":"white"},{"title":"Hispanic","value":"hispanic"},{"title":"African American","value":"african_american"},{"title":"Asian","value":"asian"},{"title":"Other","value":"other"}],"namespace":"ua.select.group"}{"title":"If other please specify","icon":"bi-pencil-square","name":"ethnicity_other","namespace":"ua.input"}{"title":"Name of School","name":"school","icon":"bi-house-check","namespace":"ua.input"}{"name":"grade","title":"Grade","icon":"bi-pencil","namespace":"ua.select.group","inner":[{"title":"Pre-Kindergarten","value":"pre-kindergarten"},{"title":"Kindergarten","value":"kindergarten"},{"title":"1st Grade","value":"1st"},{"title":"2nd Grade","value":"2nd"},{"title":"3rd Grade","value":"3rd"},{"title":"4th Grade","value":"4th"},{"title":"5th Grade","value":"5th"},{"title":"6th Grade","value":"6th"},{"title":"7th Grade","value":"7th"},{"title":"8th Grade","value":"8th"},{"title":"9th Grade","value":"9th"},{"title":"10th Grade","value":"10th"},{"title":"11th Grade","value":"11th"},{"title":"12th Grade","value":"12th"}]}

Emergency Contact Information

Please provide contact details for someone we can reach in case of an emergency.

{"title":"Emergency Contact First Name","name":"emergency_contact_firstname","placeholder":"Jonathan","required":"true","icon":"bi-file-person","minlength":"3","maxlength":"128","type":"text","namespace":"ua.input"}

{"title":"Emergency Contact Last Name","name":"emergency_contact_lastname","placeholder":"Avery Karros","required":"true","icon":"bi-file-person","minlength":"3","maxlength":"128","type":"text","namespace":"ua.input"}

{"title":"Emergency Contact Phone","name":"emergency_contact_phone","required":"true","namespace":"ua.phone"}{"title":"Emergency Contact Email","name":"emergency_contact_email","icon":"bi-envelope","namespace":"ua.input"}{"title":"Emergency Contact Relationship","name":"emergency_contact_relationship","required":"true","inner":[{"title":"Mother","value":"mother"},{"title":"Father","value":"father"},{"title":"Grandparent","value":"grandparent"},{"title":"Sibling","value":"sibling"},{"title":"Guardian","value":"guardian"},{"title":"Social Worker","value":"socialworker"},{"title":"Other","value":"other"}],"namespace":"ua.select.group"}{"title":"If other please specify","name":"emergency_contact_other_relationship","placeholder":"","icon":"bi-pencil-square","namespace":"ua.input"}

Household Members

List all members of your household, except yourself and the youth being registered. If the emergency contact is a member of the household, list them here as well. You can enter up to 10.

You can skip this section at any time by clicking the next button in the toolbar below.

Household Member 1

{"title":"Member 1 First Name","name":"additional-household-members-firstname-1","placeholder":"First Name","icon":"bi-file-person","minlength":"3","maxlength":"128","type":"text","namespace":"ua.input"}

{"title":"Member 1 Last Name","name":"additional-household-members-lastname-1","placeholder":"Last Name","icon":"bi-file-person","minlength":"3","maxlength":"128","type":"text","namespace":"ua.input"}

{"title":"Relationship of Member 1 to Youth","name":"additional-household-members-relationship-1","inner":[{"title":"Mother","value":"mother"},{"title":"Father","value":"father"},{"title":"Grandparent","value":"grandparent"},{"title":"Sibling","value":"sibling"},{"title":"Guardian","value":"guardian"},{"title":"Social Worker","value":"socialworker"},{"title":"Other","value":"other"}],"namespace":"ua.select.group"}{"title":"If other please specify for Member 1","name":"additional-household-members-other-relationship-1","placeholder":"","icon":"bi-pencil-square","namespace":"ua.input"}

{"title":"Date of Birth of Member 1","name":"additional-household-members-dob-1","required":"false","namespace":"ua.select.date"}{"title":"Gender of Member 1","name":"additional-household-members-gender-1","inner":[{"title":"Male","value":"male"},{"title":"Female","value":"female"}],"namespace":"ua.select.group"}

Household Member 2

{"title":"Member 2 First Name","name":"additional-household-members-firstname-2","placeholder":"First Name","icon":"bi-file-person","minlength":"3","maxlength":"128","type":"text","namespace":"ua.input"}

{"title":"Member 2 Last Name","name":"additional-household-members-lastname-2","placeholder":"Last Name","icon":"bi-file-person","minlength":"3","maxlength":"128","type":"text","namespace":"ua.input"}

{"title":"Relationship of Member 2 to Youth","name":"additional-household-members-relationship-2","inner":[{"title":"Mother","value":"mother"},{"title":"Father","value":"father"},{"title":"Grandparent","value":"grandparent"},{"title":"Sibling","value":"sibling"},{"title":"Guardian","value":"guardian"},{"title":"Social Worker","value":"socialworker"},{"title":"Other","value":"other"}],"namespace":"ua.select.group"}{"title":"If other please specify for Member 2","name":"additional-household-members-other-relationship-2","placeholder":"","icon":"bi-pencil-square","namespace":"ua.input"}

{"title":"Date of Birth of Member 2","name":"additional-household-members-dob-2","required":"false","namespace":"ua.select.date"}{"title":"Gender of Member 2","name":"additional-household-members-gender-2","inner":[{"title":"Male","value":"male"},{"title":"Female","value":"female"}],"namespace":"ua.select.group"}

Household Member 3

{"title":"Member 3 First Name","name":"additional-household-members-firstname-3","placeholder":"First Name","icon":"bi-file-person","minlength":"3","maxlength":"128","type":"text","namespace":"ua.input"}

{"title":"Member 3 Last Name","name":"additional-household-members-lastname-3","placeholder":"Last Name","icon":"bi-file-person","minlength":"3","maxlength":"128","type":"text","namespace":"ua.input"}

{"title":"Relationship of Member 3 to Youth","name":"additional-household-members-relationship-3","inner":[{"title":"Mother","value":"mother"},{"title":"Father","value":"father"},{"title":"Grandparent","value":"grandparent"},{"title":"Sibling","value":"sibling"},{"title":"Guardian","value":"guardian"},{"title":"Social Worker","value":"socialworker"},{"title":"Other","value":"other"}],"namespace":"ua.select.group"}{"title":"If other please specify for Member 3","name":"additional-household-members-other-relationship-3","placeholder":"","icon":"bi-pencil-square","namespace":"ua.input"}

{"title":"Date of Birth of Member 3","name":"additional-household-members-dob-3","required":"false","namespace":"ua.select.date"}{"title":"Gender of Member 3","name":"additional-household-members-gender-3","inner":[{"title":"Male","value":"male"},{"title":"Female","value":"female"}],"namespace":"ua.select.group"}

Household Member 4

{"title":"Member 4 First Name","name":"additional-household-members-firstname-4","placeholder":"First Name","icon":"bi-file-person","minlength":"3","maxlength":"128","type":"text","namespace":"ua.input"}

{"title":"Member 4 Last Name","name":"additional-household-members-lastname-4","placeholder":"Last Name","icon":"bi-file-person","minlength":"3","maxlength":"128","type":"text","namespace":"ua.input"}

{"title":"Relationship of Member 4 to Youth","name":"additional-household-members-relationship-4","inner":[{"title":"Mother","value":"mother"},{"title":"Father","value":"father"},{"title":"Grandparent","value":"grandparent"},{"title":"Sibling","value":"sibling"},{"title":"Guardian","value":"guardian"},{"title":"Social Worker","value":"socialworker"},{"title":"Other","value":"other"}],"namespace":"ua.select.group"}{"title":"If other please specify for Member 4","name":"additional-household-members-other-relationship-4","placeholder":"","icon":"bi-pencil-square","namespace":"ua.input"}

{"title":"Date of Birth of Member 4","name":"additional-household-members-dob-4","required":"false","namespace":"ua.select.date"}{"title":"Gender of Member 4","name":"additional-household-members-gender-4","inner":[{"title":"Male","value":"male"},{"title":"Female","value":"female"}],"namespace":"ua.select.group"}

Household Member 5

{"title":"Member 5 First Name","name":"additional-household-members-firstname-5","placeholder":"First Name","icon":"bi-file-person","minlength":"3","maxlength":"128","type":"text","namespace":"ua.input"}

{"title":"Member 5 Last Name","name":"additional-household-members-lastname-5","placeholder":"Last Name","icon":"bi-file-person","minlength":"3","maxlength":"128","type":"text","namespace":"ua.input"}

{"title":"Relationship of Member 5 to Youth","name":"additional-household-members-relationship-5","inner":[{"title":"Mother","value":"mother"},{"title":"Father","value":"father"},{"title":"Grandparent","value":"grandparent"},{"title":"Sibling","value":"sibling"},{"title":"Guardian","value":"guardian"},{"title":"Social Worker","value":"socialworker"},{"title":"Other","value":"other"}],"namespace":"ua.select.group"}{"title":"If other please specify for Member 5","name":"additional-household-members-other-relationship-5","placeholder":"","icon":"bi-pencil-square","namespace":"ua.input"}

{"title":"Date of Birth of Member 5","name":"additional-household-members-dob-5","required":"false","namespace":"ua.select.date"}{"title":"Gender of Member 5","name":"additional-household-members-gender-5","inner":[{"title":"Male","value":"male"},{"title":"Female","value":"female"}],"namespace":"ua.select.group"}

Household Member 6

{"title":"Member 6 First Name","name":"additional-household-members-firstname-6","placeholder":"First Name","icon":"bi-file-person","minlength":"3","maxlength":"128","type":"text","namespace":"ua.input"}

{"title":"Member 6 Last Name","name":"additional-household-members-lastname-6","placeholder":"Last Name","icon":"bi-file-person","minlength":"3","maxlength":"128","type":"text","namespace":"ua.input"}

{"title":"Relationship of Member 6 to Youth","name":"additional-household-members-relationship-6","inner":[{"title":"Mother","value":"mother"},{"title":"Father","value":"father"},{"title":"Grandparent","value":"grandparent"},{"title":"Sibling","value":"sibling"},{"title":"Guardian","value":"guardian"},{"title":"Social Worker","value":"socialworker"},{"title":"Other","value":"other"}],"namespace":"ua.select.group"}{"title":"If other please specify for Member 6","name":"additional-household-members-other-relationship-6","placeholder":"","icon":"bi-pencil-square","namespace":"ua.input"}

{"title":"Date of Birth of Member 6","name":"additional-household-members-dob-6","required":"false","namespace":"ua.select.date"}{"title":"Gender of Member 6","name":"additional-household-members-gender-6","inner":[{"title":"Male","value":"male"},{"title":"Female","value":"female"}],"namespace":"ua.select.group"}

Household Member 7

{"title":"Member 7 First Name","name":"additional-household-members-firstname-7","placeholder":"First Name","icon":"bi-file-person","minlength":"3","maxlength":"128","type":"text","namespace":"ua.input"}

{"title":"Member 7 Last Name","name":"additional-household-members-lastname-7","placeholder":"Last Name","icon":"bi-file-person","minlength":"3","maxlength":"128","type":"text","namespace":"ua.input"}

{"title":"Relationship of Member 7 to Youth","name":"additional-household-members-relationship-7","inner":[{"title":"Mother","value":"mother"},{"title":"Father","value":"father"},{"title":"Grandparent","value":"grandparent"},{"title":"Sibling","value":"sibling"},{"title":"Guardian","value":"guardian"},{"title":"Social Worker","value":"socialworker"},{"title":"Other","value":"other"}],"namespace":"ua.select.group"}{"title":"If other please specify for Member 7","name":"additional-household-members-other-relationship-7","placeholder":"","icon":"bi-pencil-square","namespace":"ua.input"}

{"title":"Date of Birth of Member 7","name":"additional-household-members-dob-7","required":"false","namespace":"ua.select.date"}{"title":"Gender of Member 7","name":"additional-household-members-gender-7","inner":[{"title":"Male","value":"male"},{"title":"Female","value":"female"}],"namespace":"ua.select.group"}

Household Member 8

{"title":"Member 8 First Name","name":"additional-household-members-firstname-8","placeholder":"First Name","icon":"bi-file-person","minlength":"3","maxlength":"128","type":"text","namespace":"ua.input"}

{"title":"Member 8 Last Name","name":"additional-household-members-lastname-8","placeholder":"Last Name","icon":"bi-file-person","minlength":"3","maxlength":"128","type":"text","namespace":"ua.input"}

{"title":"Relationship of Member 8 to Youth","name":"additional-household-members-relationship-8","inner":[{"title":"Mother","value":"mother"},{"title":"Father","value":"father"},{"title":"Grandparent","value":"grandparent"},{"title":"Sibling","value":"sibling"},{"title":"Guardian","value":"guardian"},{"title":"Social Worker","value":"socialworker"},{"title":"Other","value":"other"}],"namespace":"ua.select.group"}{"title":"If other please specify for Member 8","name":"additional-household-members-other-relationship-8","placeholder":"","icon":"bi-pencil-square","namespace":"ua.input"}

{"title":"Date of Birth of Member 8","name":"additional-household-members-dob-8","required":"false","namespace":"ua.select.date"}{"title":"Gender of Member 8","name":"additional-household-members-gender-8","inner":[{"title":"Male","value":"male"},{"title":"Female","value":"female"}],"namespace":"ua.select.group"}

Household Member 9

{"title":"Member 9 First Name","name":"additional-household-members-firstname-9","placeholder":"First Name","icon":"bi-file-person","minlength":"3","maxlength":"128","type":"text","namespace":"ua.input"}

{"title":"Member 9 Last Name","name":"additional-household-members-lastname-9","placeholder":"Last Name","icon":"bi-file-person","minlength":"3","maxlength":"128","type":"text","namespace":"ua.input"}

{"title":"Relationship of Member 9 to Youth","name":"additional-household-members-relationship-9","inner":[{"title":"Mother","value":"mother"},{"title":"Father","value":"father"},{"title":"Grandparent","value":"grandparent"},{"title":"Sibling","value":"sibling"},{"title":"Guardian","value":"guardian"},{"title":"Social Worker","value":"socialworker"},{"title":"Other","value":"other"}],"namespace":"ua.select.group"}{"title":"If other please specify for Member 9","name":"additional-household-members-other-relationship-9","placeholder":"","icon":"bi-pencil-square","namespace":"ua.input"}

{"title":"Date of Birth of Member 9","name":"additional-household-members-dob-9","required":"false","namespace":"ua.select.date"}{"title":"Gender of Member 9","name":"additional-household-members-gender-9","inner":[{"title":"Male","value":"male"},{"title":"Female","value":"female"}],"namespace":"ua.select.group"}

Household Member 10

{"title":"Member 10 First Name","name":"additional-household-members-firstname-10","placeholder":"First Name","icon":"bi-file-person","minlength":"3","maxlength":"128","type":"text","namespace":"ua.input"}

{"title":"Member 10 Last Name","name":"additional-household-members-lastname-10","placeholder":"Last Name","icon":"bi-file-person","minlength":"3","maxlength":"128","type":"text","namespace":"ua.input"}

{"title":"Relationship of Member 10 to Youth","name":"additional-household-members-relationship-10","inner":[{"title":"Mother","value":"mother"},{"title":"Father","value":"father"},{"title":"Grandparent","value":"grandparent"},{"title":"Sibling","value":"sibling"},{"title":"Guardian","value":"guardian"},{"title":"Social Worker","value":"socialworker"},{"title":"Other","value":"other"}],"namespace":"ua.select.group"}{"title":"If other please specify for Member 10","name":"additional-household-members-other-relationship-10","placeholder":"","icon":"bi-pencil-square","namespace":"ua.input"}

{"title":"Date of Birth of Member 10","name":"additional-household-members-dob-10","required":"false","namespace":"ua.select.date"}{"title":"Gender of Member 10","name":"additional-household-members-gender-10","inner":[{"title":"Male","value":"male"},{"title":"Female","value":"female"}],"namespace":"ua.select.group"}

Application Questions

{"maxlength":1200,"title":"Why does your child want, or why do you want your child to participate in a mentoring program?","name":"reason","minlength":15,"required":"true","namespace":"ua.doc.simple"}{"maxlength":1200,"title":"Briefly describe your expectations of the mentoring program.","name":"expectations","minlength":15,"required":"true","namespace":"ua.doc.simple"}{"title":"Available for at least 1 hour per week?","name":"availability","required":"true","inner":[{"title":"Yes","value":"yes"},{"title":"No","value":"no"}],"namespace":"ua.select.group"}{"maxlength":1200,"title":"If no, explain scheduling issues.","name":"scheduling_issues","namespace":"ua.doc.simple"}{"maxlength":1200,"title":"Describe your child's school performance.","name":"school_performance","namespace":"ua.doc.simple"}{"maxlength":1200,"title":"Does your child have friends? Describe friendships.","name":"friendships","namespace":"ua.doc.simple"}{"maxlength":1200,"title":"Any current problems at home or school?","name":"current_problems","namespace":"ua.doc.simple"}{"maxlength":1200,"title":"Any traumatic events experienced?","name":"trauma_history","namespace":"ua.doc.simple"}{"maxlength":1200,"title":"Additional helpful background information.","name":"background_info","namespace":"ua.doc.simple"}{"maxlength":1200,"title":"Religious preferences to consider.","name":"religious_preferences","namespace":"ua.doc.simple"}{"maxlength":1200,"title":"Anyone your child should not contact?","name":"restricted_contacts","namespace":"ua.doc.simple"}

Medical History

{"title":"Primary Care Physician","name":"physician","namespace":"ua.input"}{"title":"Physician Phone","name":"physician_phone","namespace":"ua.phone"}{"title":"Medical Insurance Provider","name":"insurance_provider","namespace":"ua.input"}{"title":"Policy Number","name":"policy_number","namespace":"ua.input"}{"title":"Insurance Phone","name":"insurance_phone","namespace":"ua.phone"}{"title":"Any physical problems or limitations?","name":"physical_limitations","inner":[{"title":"Yes","value":"yes"},{"title":"No","value":"no"}],"namespace":"ua.select.group"}{"maxlength":1200,"title":"If yes, please explain.","name":"physical_explain","namespace":"ua.doc.simple"}{"title":"Receiving treatment for medical issues?","name":"medical_treatment","inner":[{"title":"Yes","value":"yes"},{"title":"No","value":"no"}],"namespace":"ua.select.group"}{"maxlength":1200,"title":"If yes, please explain.","name":"treatment_explain","namespace":"ua.doc.simple"}{"title":"Taking medications?","name":"medications","inner":[{"title":"Yes","value":"yes"},{"title":"No","value":"no"}],"namespace":"ua.select.group"}{"maxlength":1200,"title":"If yes, please explain.","name":"medications_explain","namespace":"ua.doc.simple"}{"title":"Any allergies or adverse reactions?","name":"allergies","inner":[{"title":"Yes","value":"yes"},{"title":"No","value":"no"}],"namespace":"ua.select.group"}{"maxlength":1200,"title":"If yes, please explain.","name":"allergies_explain","namespace":"ua.doc.simple"}{"title":"Any emotional issues right now?","name":"emotional_issues","inner":[{"title":"Yes","value":"yes"},{"title":"No","value":"no"}],"namespace":"ua.select.group"}{"maxlength":1200,"title":"If yes, please explain.","name":"emotional_explain","namespace":"ua.doc.simple"}{"title":"Currently seeing a counselor or therapist?","name":"counseling","inner":[{"title":"Yes","value":"yes"},{"title":"No","value":"no"}],"namespace":"ua.select.group"}{"maxlength":1200,"title":"If yes, please explain.","name":"counseling_explain","namespace":"ua.doc.simple"}

Contact and Information Release

By checking the boxes below, you provide OBK with permission to contact your child, share information as needed to match them with a mentor, and disclose identifying details after a match is made.

{"title":"I grant permission for OBK to contact my child and conduct an interview for mentee enrollment.","name":"release_contact_consent","required":"true","namespace":"ua.checkbox"}{"title":"I understand that anonymous information about my child may be shared with potential mentors to aid in determining a suitable match.","name":"release_anonymous_match","required":"true","namespace":"ua.checkbox"}{"title":"I consent to sharing identifying information with a selected mentor once a match has been made.","name":"release_match_details","required":"true","namespace":"ua.checkbox"}

Consent & Agreements

Please agree to each of the following:

{"title":"I give my informed consent and permission for my child to participate.","name":"consent_participation","required":"true","namespace":"ua.checkbox"}{"title":"I agree to have my child follow all mentoring program guidelines.","name":"consent_guidelines","required":"true","namespace":"ua.checkbox"}{"title":"I acknowledge that my child may be transported by his/her mentor at own risk.","name":"consent_transport","required":"true","namespace":"ua.checkbox"}{"title":"I release the program of all liability except gross negligence.","name":"consent_liability","required":"true","namespace":"ua.checkbox"}

{"title":"I have read and agree to the statements below:","name":"agreetoterms","required":"true","class":"pt-3 fs-4","namespace":"ua.checkbox"}

1. I agree to The Universe Terms of Service and Privacy Policy.

2. By submitting, you agree that we may contact you via email, SMS, or phone with newsletters, marketing communications, and product updates (automated or direct), and we may also reach out with questions related to your submission.

Thank you!

I understand, that my application will be reviewed and I'll be asked to signed application, and may need proof of my legal guardianship.

{"title":"Parent/Guardian Signature","name":"signature_parent","required":"true","placeholder":"Please type your full name.","minlength":3,"namespace":"ua.input"}

Youth Mentee Guidelines

Please read and agree to the following guidelines:

Be dependable and punctual.
Never meet alone with your mentor in private places.
No photos or info shared on social media.
Refer concerns to your guardian/contact person.
Never take medication from a mentor.
No smoking, drinking, or drugs while with mentor.
Respect mentor's privacy.
Respect cultural, social, and religious differences.
No travel with mentor without written consent.
Keep promises sparingly but faithfully.
Mentor/mentee assignments may change if requested.
No weapons allowed when meeting mentor.

{"title":"Youth Mentee Signature","name":"youth_signature","required":"true","placeholder":"Type thier full name.","minlength":3,"namespace":"ua.input"}{"title":"Parent/Guardian's Signature","name":"parent_signature_guidelines","required":"true","placeholder":"Type thier full name.","minlength":3,"namespace":"ua.input"}