AGENCY REFERRAL FORM

 Both parents, guardians, and/or agencies may refer a child to Mentoring Cochise Kids (MCK). Agencies and/or parents/guardians may fill out the Referral Form below and submit.

Thank you for considering MCK. It is our desire to match children referred to us with a mentor who will provide a caring hand and sound guidance as they struggle to make good choices. Our volunteers are caring adults who want to help a youth succeed. They don’t try to replace parents or act like a professional youth counselor.

MCK will seek to match each child with a mentor who shares common interests, but also lives within a reasonable distance from the child’s residence. Mentors assume responsibility for scheduling times together with their mentee and for all transportation. Not only are our mentors given a background check by a professional screening company, but if they transport their mentee at any time, they must have a current driver’s license, clean driving record and proof of insurance.

Unfortunately, we have a limited supply of qualified mentors so we can’t promise that we will be able to bring each child into our program immediately. However, we will do everything possible to find just the right volunteer to help as soon as possible. Once a mentee has been accepted into the program, they are allowed to come to the activities with a chaperone even though they may not be matched yet.

Once again, the first step in the process of finding a mentor for the child you wish to refer is to submit our online Referral Form. As always, we are happy to answer any questions you might have throughout the process. You can contact our office by phone at 520-977-3870 or by e-mail at mentoringcochisekids@gmail.com.

Thank you again for placing your trust in Mentoring Cochise Kids. We look forward to working with you and your child.

Sincerely,

Sue Dupee, Mentor Coordinator

Agency Referral Form

MENTORING COCHISE KIDS REFERRAL FORM This form, and the signed parent permission form, are to be completed by the referral agency, or the parent/guardian, and returned to MCK. Information on this form will be kept confidential and will be used to assist the mentor coordinator in matching the child with an appropriate mentor. Please fill in as much information as possible. Download a print version of the form here.