Parent/ Guardian Forms

Thank you for your interest in the Black Bear Mentors Program.

The Black Bear Mentors Program is active at the Old Town Elementary School, Leonard Middle School (Old Town) and the Lewis Libby School (Milford).  

Please complete this parent form to request a mentor for your child.

If you have any questions please contact:

MacKayla Faloon, Mentoring Coordinator
(207)-581-1786
um.blackbearmentors@maine.edu
139 Rangeley Road, Orono, ME 04469

In complying with the letter and spirit of applicable laws and pursuing its own goals of diversity, the University of Maine System does not discriminate on the grounds of race, color, religion, sex, sexual orientation, transgender status, gender, gender identity or expression, ethnicity, national origin, citizenship status, familial status, ancestry, age, disability physical or mental, genetic information, or veterans or military status in employment, education, and all other programs and activities.  The University provides reasonable accommodations to qualified individuals with disabilities upon request. The following person has been designated to handle inquiries regarding non-discrimination policies: Director of Equal Opportunity, 5713 Chadbourne Hall, Room 412, University of Maine, Orono, ME  04469-5713, 207.581.1226, TTY 711 (Maine Relay System).