Mentee Application

Greetings Caregiver,

We are excited to welcome your child to DREAM!

DREAM is a year-round program that offers mentoring, adventure programming, afterschool enrichment and summer camp. As part of the program, your child will be matched with a caring undergraduate mentor. Our staff and volunteers are extensively screened and trained, to bring safe and high quality programming to your child.

This enrollment form takes about 30 minutes to complete and is necessary to ensure the safety and fun for all our DREAMers. We appreciate your time and are eager to start!

Please be in touch (info@dreamprogram.org or 802-338-8979) if you have any questions or have any difficulty submitting this form.

Thank you!

Youth Information

Youth First Name *This question is required.

Youth Last Name *This question is required.

Nickname/Preferred Name

Youth Date of Birth *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

If you said other, please specify.

Youth Street Address *This question is required.

Apt/Suite

City *This question is required.

Zip *This question is required.

Youth Personal Email Address
A parent email is fine if youth does not yet have one. *This question is required. This question requires a valid email address.

Primary Phone Number
A parent phone number is fine if youth does not yet have one, yet please make sure this is a mobile/cell number. *This question is required.

Youth Secondary Phone Number

If you said other, please specify. *This question is required.

Youth's Preferred language/s *This question is required.

Arabic
Burmese
Chinese / Mandarin
English

French
Haitian Creole
Hindi
Khmer

Kirundi / Rundi
Korean
Mai-Mai
Nepali

Portuguese
Spanish
Somali
Swahili

Vietnamese
Other

If you said other, please specify. *This question is required.

Community Youth Lives in *This question is required.

If you said other, please specify. *This question is required.

School Youth Attends *This question is required.

Does the youth receive free/reduced lunch at school? *This question is required.

Which DREAM programs are you interested in enrolling your youth in? *This question is required.

Village Mentoring: school-year weekly mentoring time and DREAM Days
Summer DREAM: daily summer enrichment activities in your neighborhood
Camp DREAM: overnight summer camp in Northern Vermont
Adventure Programming: periodic local and regional adventure trips throughout the year

Does the youth participate in another mentoring program or other after-school groups? *This question is required.

If you said yes, please specify the program(s). *This question is required.

May DREAM reach out to a teacher of your child or other school personnel to support your child's schoolwork, mental and physical health, and wellbeing? *This question is required.

Mentee Application

Welcome!