Youth Mentoring Request

806-478-2565

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Youth Mentoring Request Form

* Indicates required field

Parent's Name(s) *

First

Last

Child's Name *

First

Last

Email *

Phone Number *

Tell us about your child and why you are interested in mentoring: *

We do not charge fees for mentoring. Will you be able to help support our ministry with financial offerings while your child is being mentored? *

Yes No Not sure

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