This form is used by parents/guardians to apply for a youth to enter our mentorship program.

THIS FORM IS NOT FOR THE PRE-TRIAL INTERVENTION PROGRAM. All pre-trial participants must be referred by the court system. 

Mentee Eligibility Requirements:

• Be 8–17 years old
• Reside within 25 miles of Defuniak Springs
• Demonstrate a desire to participate in the program and be willing to abide by all FCM Mentoring Program policies and procedures
• Be able to obtain parental/guardian permission and ongoing support for participation in the program 
• Agree to a one-year commitment to the program
• Commit to spending a minimum of eight hours a month with the mentor
• Be willing to train (minimum 2 days per week) and COMPETE through USA Boxing or other approved athletics program
• Agree to attend a church ran youth group at least twice per month
• Be willing to communicate with the mentor weekly
• Complete screening procedure
• Agree to attend mentee trainings as required
• Be willing to communicate regularly with the program director and discuss monthly meeting and activity information