Teen Mentoring Program Referral Form

Who may qualify for this program?

  • Teen males and females

  • Teens who have engaged in risky behaviors

  • Teens willing to participate in a group setting with others their age

  • Teens willing to meet one-on-one with RETA staff member

  • Teens who can meet in-person

  • Teens whose guardian(s) agree to meet with the facilitator before the program beings to understand what will be taught to their teen

Who may not qualify for this program?

  • Individuals with a diagnosed sexually-related disorder

  • Individuals with a rape/assault charge

  • Individuals with a felony charge

  • Individuals who previously were unsuccessful in completing this program

  • Other reasons at discretion of provider

Clients who these criteria apply to should not be referred. Please contact RETA with questions.