GLUE/One-on-One Mentor Sessions
As part of our free mentoring services, we are now offering One-On-One Mentoring Sessions. These sessions are geared towards young ladies in grades 4 - 12. Since we can't tackle all things via our group sessions, one-on-one mentoring allows for confidentiality and direct support.  

One-On-One mentoring requires parental/legal guardian consent.

The initial meeting will consist of the mentee and parent/guardian to discuss ground rules and requirements.

See the available times below and provide your responses. The goal is to meet twice a month. Please be mindful and schedule a day and time to commit to.

Meetings will be in 30min increments - if your require more time, please annotate with a comment below.

Meeting Location: Zoom Virtual Meeting *Each mentee will receive their own unique passcode to use for their session(s).

PLEASE BE ADVISED THAT COMPLETING THIS FORM DOES NOT GUARANTEE SERVICES. YOU WILL BE CONTACTED WITHIN 48HRS OF RECEIPT OF THIS FORM.

FOR QUESTIONS ABOUT THIS FORM OR QUESTIONS PRIOR TO COMPLETING THIS FORM, PLEASE TEXT: 240-583-1959
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Email *
Parent Name (First & Last Name) *
Child's Name (First & Last Name) *
Child's Age *
Child's DOB (Date of Birth) *
MM
/
DD
/
YYYY
Child's Current Grade Level
Select One
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
What times are you available?
Please select all that apply
Afternoon
Evening
3:00pm - 3:30pm
4:00pm - 4:30pm
5:00pm - 5:30pm
6:00pm - 6:30pm
7:00pm - 7:30pm
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
If your available time is not listed above, please provide your availability below.
Items to discuss?
Topics of Conversation (Select All That Apply) *
Required
Please be advised that One-On-One mentor services offered by Girls Like Us Evolving, Inc, should not be substituted for professional mental health services/counseling. All sessions are confidential, however, if the Mentor is made aware of any potential harm (abuse, self-inflicted harm, neglect) the proper law enforcement authorities will be notified. (Please Print name and Date to Consent) *
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