Referral Form for Youth Mentorship

The purpose of this form is to recommend resettled clients for Youth Mentorship, which provides an adult volunteer to a refugee high school or junior high student.

A youth mentor befriends a refugee high school or junior high student, providing regular ongoing support. Refugee youth are empowered through mentorship, cultural orientation, guidance, and friendship.

  • Refugee Care Collective partners with all local resettlement agencies. This program is for R&P, ECM, and LCSNW PC-ICM and PIP programs. It is for those with current or prior refugee status, as well as for those from Afghanistan who were granted humanitarian parole.
  • Please fill out this form to the best of your ability. We will not contact potential clients without contacting you first.
  • This form is not for volunteers to do transportation or one-off requests. It is for long-term volunteers to support a refugee youth for one year.

If you have not heard back within 48 hours, please email directly.


"*" indicates required fields

This helps us match volunteers. Include intersection or area of city if you don't have the full address. Include "Temporary Housing" if that's the case.
Month and year format.
Ex. Catholic Charities of Oregon, Ecumenical Ministries of Oregon, IRCO, Lutheran Communities Services Northwest
Has this person expressed interested in this program?
Priority Level*
Level of English:
Student Needs Helps With:
Please share as much information you are able to, at this time, about youth and their family.

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