Route 21 Youth Application

Route 21 Application

Requirements

Route 21 youth…

1. Are currently in foster care or were in foster care and the attachment is not going well. We call it ‘growing out of foster care.’
2. Are current 8th graders. We understand there are a lot of youth who are older and younger than 8th grade who need help but but one of the great strengths of the Route 21 mentoring model is the length of relationships that are formed. Because of this we ask that you only apply if your youth is an 8th grader. 

Thank you for taking the time to fill out this questionnaire. The questionnaire is vital in helping Route 21 serve your youth well. All information is kept confidential.

*Please wait to tell your youth about the program until we know they are a good fit. 

Case Worker's Name
Guardian/Foster Care Parent Name(Required)
Is your youth currently in foster care?
Address(Required)
Student's Name(Required)
Please check the boxes that you are concerned about for your youth.
Do you plan on moving in the next four years?
Route 21 mentors and staff have video cameras in their car to record all activities in the car while they are with youth. The footage will never be used for promotion or advertising. The footage is just used to keep Route 21 youth and staff safe. Are you okay with your youth being recorded while in the car with Route 21 staff?

Thank you for taking the time to fill out this application. The questions help us serve your youth better. Route 21 will get back to you shortly.


Route 21 Mentor Application