Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Mentor Program Contact and Information Release Form

    To Be Completed by the Parent/Guardian
  2. I hereby grant permission for Bowie Youth & Family Services (BYFS) Teen Mentor Program (TMP) to make contact with my child and conduct a personal interview for the purposes of applying to be a mentee. Staff may also make contact with my child on school premises for the purposes of screening and interviewing as well as ongoing support of his/her participation in the mentoring program.*
  3. Further, I understand that basic information about my child will be anonymously (without names) shared with a prospective mentor(s) to aid in determining a suitable match. Once a mentor/mentee match is determined, mine and my child’s identity and other relevant information will be shared with the mentor to the extent it aids in facilitating a successful match.*
  4. Photo Release: I grant to BYFS TMP, its representatives and employees the right to take photographs of my child and my property in connection with the above-named organization. I authorize its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that BYFS may use such photographs of my child with or without my name and for any lawful purpose, including such purposes as publicity, illustration, advertising, and Web content.*
  5. Leave This Blank:

  6. This field is not part of the form submission.