.enroll a child.....

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If you would like more information or to talk to somebody before applying to become a mentor, please contact David Doozan at ddoozan.dfad@gmail.com or phone 269 779 3320.

information about the child......

Name *

Date Of Birth *

Age *

Cell Phone *

Email Address *

School *

Grade *

Graduation Year *

Gender *

Ethnicity *

Contact With Father *

guardian information.....

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Name *

do you rent or own? *

email address *

job title

Address *

employer

martial status

how long have you lived at this address? *

cell phone *

highest level of education

emergency contact info.....

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Name *

relationship *

home phone *

cell phone *

ABOUT THE FATHER...

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What is the child’s father name? *

How often does he see his father? *

Where does the father live? *

release of information....

The information given above is correct and accurate to the best of my knowledge and I understand that this application constitutes a request to Dads for A Day, Inc. to involve my child in their program. I further understand that Dads for A Day, Inc. may or may not accept my child, based upon pre-established criteria that is subject to change without notice. I realize that Dads for A Day, Inc. is not obligated or required to assign, or actively seek to assign a Dads for A Day, Inc. volunteer mentor for my child. I understand that I will have the opportunity of learning about a potential volunteer mentor before a match is made, and that I will have the option to accept the candidate selected by the Dads for A Day, Inc. staff.

I release Dads for A Day, Inc., its staff, directors, and volunteers from any responsibilities or liability resulting from the match of my child.

Furthermore, I release Dads for A Day, Inc., its staff, Directors, and volunteers from any liability due to my child's participation in any activities sponsored by Dads for A Day, Inc.

I give permission for my child to receive age appropriate, Christian based, sex education training. I have the option to opt-out my child if I choose to do so.

I give permission for my child's picture or video to be taken and displayed in the agency office or in any publications or media after being matched with a volunteer mentor.

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name of parent/guardian *

Date *

.WHO WE ARE.....

Dads For A Day is a faith-based volunteer nonprofit agency that provides positive male role models and mentoring programs for at-risk youth growing up in homes without dads.

.WHAT WE DO.....

We teach our mentees important virtues and life lessons to help them break the generational cycles of addiction, poverty, violence, suicide, and family abandonment. We give them character, we give them faith, we give them hope for the future.

We also help our the young men explore educational opportunities and career choices while learning the importance of solid work ethics.

.WHY WE DO IT.....

Because the people of God should care for the fatherless. James 1:27 tells us: Religion that God our Father accepts as pure and faultless is this: To care for orphans and widows in distress…

.WHAT IS THE MENTOR’S ROLE.....

Spend at least two hours a week with your child.
Plan fun activities with input from you and your child.
May take your child on planned group activities with other children in the program.
Always keep you informed of where he has taken your child and what was discussed.

.WHAT IS YOUR ROLE.....

Coordinate calendar of activities with the mentor.
Participate in the first-year training program.
Provide emergency contact information to the mentor.
Talk with your son about the lesson focus.

.WHAT IS YOUR SON’S ROLE.....

Be ready at the appointed time for the meetings.
Participate in the first-year training program.
Assist in the planning of activities with his mentor.
Show respect for the mentor at all times.

.HOW DO WE DO IT.....

We provide each fatherless youth with a Christian male role model who is fully trained, carefully matched, and has experience raising a family of his own or otherwise working with youth. Each of these mentors have also passed extensive background checks and personal interviews.

Every mentor accepted to the program is required to pass a background check, provide two character references, possess a valid driver’s license, and carry liability insurance on his automobile.

269 779 3320

DDoozan.DFAD@gmail.com

.enroll a child.....

information about the child......

guardian information.....

emergency contact info.....

ABOUT THE FATHER...

release of information....

.WHO WE ARE.....

.WHAT WE DO.....

.WHY WE DO IT.....

.WHAT IS THE MENTOR’S ROLE.....

.WHAT IS YOUR ROLE.....

.WHAT IS YOUR SON’S ROLE.....

.HOW DO WE DO IT.....

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