Join Kids2Career

This parent must already be part of the Proverbs 22:6 program.

Parent's full name

Parent's ID number

State where the parent is serving or served

Is the parent released?

YesNo

Tell us about the child joining the program.

Child's full name

Child's date of birth

Child's email addressOptional

Child's phone numberOptional

Child's school name

Current grade

Career choice 1

Career choice 2

Career choice 3

Child's gender

MaleFemale

The adult we will contact about mentoring, events and scholarships.

Caregiver's full name

Relationship to the child

Street

City

State

ZIP

Caregiver's email address

Caregiver's phone number

Preferred way to be contacted

ComputerPhoneTexting

Computer access at homeThis tells us if the child can join virtual mentoring.

No InternetInternet — WiredInternet — Wireless

Phone access at home

No InternetInternet — WiredInternet — Wireless

Your information is protected and is never sold or shared.

Know a child who needs a mentor?