Mentor Match Youth Referral Form

Please complete the following Mentor Match referral to aid in the matching process. You are able to save and return to this form if needed. Incomplete referrals will not be processed. If you have any questions, please contact mentor@cfknc.org

Referring Individual

Your Full Name *This question is required.

Your Email Address *This question is required. This question requires a valid email address.

Your Phone Number *This question is required.

If you said other, please specify.

In which county did the youth you are referring to the program come into care? *This question is required.