8th Grade Mentoring Parent Permission Form

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Levi P. Dodge Middle School has the unique opportunity to work with the Dakota County 4-H, University of Minnesota Extension, mentoring program. The program pairs high school students with middle school students to establish positive connections, ease anxieties about the transition to high school, and encourage excitement for their educational career. DMS 8th grade students will meet with their mentor from 3:00-3:30 pm for 6 sessions.

For DMS students to benefit from this program and the mentoring program to recieve funding , students names need to be entered with Minnesota 4-H Youth Development system. By filling out the online Google form, you are giving permission for your child to participate in the mentoring program and have the mentoring coordinator enter their name . There are no further actions need by you, no fees or further commitments.

If you would like more information about the 4-H mentoring program, please contact Kirsten Pederson, Dakota County 4-H Extension Educator, at 952-240-7947.

Student Name (Last, First) *

Parent/Guardian Name (Last, First) *

Please select the box below to give permission for your student to particpate (if you have more than one 8th grader at DMS, please fill out the form for each student). *

I give permission for my student to participate in mentoring at DMS and be enrolled with Minnesota 4-H Youth Development mentor program(at no cost or commitment from our family)

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