Youth Registration for Mentoring
This form is intended for families of elementary school children who want to register to participate in the Skamania County WSU Extension Youth Mentoring program. This application is for youth in grades K-5. If you wish to register for 6th and above, please see the Teen Mentor Application. Registration is open until all spots are filled. For questions, please contact Phoebe Jud at phoebe.jud@wsu.edu 
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Youth Mentee Information
Full Name *
Birthdate *
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DD
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Grade *
Which school does your child attend?
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Race/Ethnicity (check all that apply
Days available for mentoring (please check all that apply)
Times available for mentoring (please check all that apply)
Please list any dietary restrictions
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