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Mentor Application
Name
(Required)
First
Last
Student ID (T#)
(Required)
Email
(Required)
Phone
Check all that apply
(Required)
Faculty
Staff
Student
What year are you in?
(Required)
Sophomore
Junior
Senior
Graduate
Major
(Required)
GPA
(Required)
Anticipated graduation date
(Required)
MM slash DD slash YYYY
Please answer the following questions in complete sentences.
Why do you want to become a mentor?
(Required)
Do you have any previous experience mentoring, tutoring or in a leadership position in a student organization? If so, please specify.
(Required)
What skills, knowledge, or other attributes do you feel you have that would benefit a mentee? Please explain.
(Required)
Cultural/creative/social activities that you enjoy and would like to share with a mentee.
(Required)
Is there any additional information you would like us to consider for your candidacy?
(Required)
By clicking the following statements, acknowledging your understanding of the requirements and responsibilities of being a mentor.
(Required)
I agree
1. I will commit to a minimum of one academic year to this program.
2. I will commit a minimum of spending 2 hours twice monthly with my mentee.
3. I will communicate in a timely manner with my program staff, provide monthly information regarding my mentoring activities, and receive feedback regarding any difficulties during my participation in the mentor program.
4. I will attend the initial mentor training session and any additional training sessions during the academic year.
5. I will NOT use alcohol or controlled substances in an excessive or inappropriate manner.
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