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Candidate Data:
First Name: 
Last Name: 

Date of Birth:









Dover Middle School



Guardian Info:

First Name:


Last Name:



10 Avon Ave #2




Guardian/Family Phone:

Guardian/Family Email Address:

Living Situation:


Owen lives with his grandmother, both of his parents have died in the last 8 months

Financial Situation:


Free/Reduced Lunch:



How many live in the household?


How many work and/or provide income to support the household?


Household Situation:

Owen has lost both of his parents over the last 8 months due to tragic circumstances. First his mother died and Owen, along with his dad and younger brother moved in with his grandmother, Darlene. Then two months ago his father died. As a result of his mother's passing the family lost their home, had to give away their pets and had to leave the parochial school that they attended. Owen's grandmother is retired and I am unsure of her financial status. With us being in Virtual Learning we have not had families submitting requests for free and reduced lunch since we have offered breakfast and lunch for free which will continue as we start our re-entry process. Needless to say this has been a very disruptive time for Owen in his life and participating in a program like Mayhew would be one step towards Owen beginning to recover. Owen's grandmother is trying her best, but was unprepared for taking this new challenge on and so we have offered a great deal of support to her and the boys. Also in his life is his great aunt, Kelley who is also working to help the boys and her sister with all of these changes and challenges.

Organizations / Mentor Programs:

None at this time.

Special Assistance:

Owen does not have an IEP nor does he require any special services. I have been meeting with Owen during Virtual Learning through ZOOM while in breakout rooms. Owen has not yet been receptive to any outside counseling but his grandmother does have Ronan seeing our community mental health partner, Community Partners in Dover and they do a family systems approach. The hope is that Owen will see that this is a good thing and will also agree to start one to one counseling.

Health Concerns:


Victim of Sexual Abuse:


Perpetrator of Sexual Abuse:


Victim of Physical Abuse:


Threatening or Aggressive Behavior:


Required Physical Restraint:


Personality / Social Standing:

Owen is considered to be introverted by his teachers. Owen appears to be a follower and not a leader based on our interactions with him. He does not participate in groups when in small group breakout rooms. I will say that this has been difficult for kids because they came from three different elementary schools and have never been together in person. I do think that Owen would handle social situations and would benefit from the team building and leadership components of being at Mayhew.

Behavioral Patterns:

Owen can really be so enjoyable to talk to when you catch him at the right moment. While Owen would balk at his teacher's requests to be on camera and to speak, when I had him one to one, he would get on camera and talk to me. One of the things that I learned in one of those conversations is that one of the things he enjoyed doing with his mom was cooking. When talking to his dad before he died was his sadness over not having that same passion. Owen's behavior is definitely a roller coaster right now and I would expect that over the next several months as his loss and grief surface in different ways that other things will arise. I can so picture him feeling a sense of renewal and being able to breathe while out on the island and just being able to be a kid without all of the other pieces that he is carrying but also being able to have others on the island who have also experienced loss.


If there is a boy that I needs to be surrounded by other boys and male role models at a pivotal point in their lives Owen is at the top of that list. It is hard to overstate the degree to which these next few months will have in his overall well being. Owen was the one who discovered his father, called 911 and performed CPR only to have his father die. Coming back from that will not only require the love of his grandmother and great aunt but him having mentors and friends who will be there for him. I have been so fortunate to have so many other boys be accepted at Mayhew and I can only hope that Owen is another one to start his journey with the camp. Owen may not recognize or understand what it is he is feeling nor have the words to use for what is in his head, but being out on the fields, out in the canoes, helping cook meals at the campfire would provide the resources for him to see a way forward through this grief. I have witnessed first hand the long term impact that Mayhew has -it is inspiring.