Your generous donation can make a real difference in the lives of those we serve. Every contribution, no matter the size, helps us continue our work and expand our reach. Click here to give the gift of hope and opportunity.

Interested in becoming one of our mentors?

MENTOR

Interested but need more information.

MENTEE QUESTIONNAIRE

Thank you for your interest in WESOURCE: The Village Connection! This questionnaire will help us understand your needs and how we can best support your personal growth and development. Please answer all questions honestly. Your responses will remain confidential.

First name

Last name

Birthday

Month

Day

Year

Age

Email

Preferred Contact

Parent/Guardian Full Name

EDUCATION

Current School or Educational Program

Grade Level

Do you need support with any of the following? (Select all that apply.)

PERSONAL DEVELOPMENT & SOCIAL SKILLS

EMOTIONAL WELL-BEING & MENTAL HEALTH

Would you like support in any of the following? (Select all that apply.)

FAMILY & COMMUNITY SUPPORT

Who are your biggest supporters in your life? (e.g. family, friends, teachers, mentors)

Are there family-related challenges you would like guidance on? (Select all that apply.)

HOBBIES & INTERESTS

Would you like to explore any new hobbies or skills?

Yes

No, I'm happy with my current interests.

If yes, please specify.

FUTURE GOALS & ASPIRATIONS

List your short-term goals.

List your long-term goals.

What areas do you think a mentor could help you with? (Select all that apply.)

ADDITIONAL COMMENTS

Is there anything else you would like us to know to better support you?

ACKNOWLEDGEMENT & CONSENT

By submitting this form, I acknowledge that the information provided is accurate to the best of my knowledge. If under 18, I understand that my parent/guardian may be contacted regarding my participation in the program.

Mentee Signature and Date

Signature field is empty.

Parent/Guardian Signature and Date

Signature field is empty.

WESOURCE emphasizes the need for support and guidance to help children make informed educational decisions for their future. While 43% of adults currently work in their childhood dream jobs and 19% have done so previously, many young people lack the trust, love, and support necessary to take proactive steps toward their goals. This highlights the importance of early intervention and encouragement in shaping their futures.

Your gift today can help change a child's future.

CLICK BELOW TO DONATE OTHER AMOUNTS.