Name(Required) First Last Email(Required) Contact Number(Required)Class Level(Required) Freshman Sophomore Junior Senior Academic Major(Required) Ethnicity Black/African American Asian, American/Pacific Islander/Desi American Hispanic/Latinx/a/o Indigenous (Native American, Alaskan, Hawaiian) White Multiethnic Which affinity mentoring groups do you identify with? (Select all that apply) Students with Dependents First-Generation Students Latina/x Students Asian, American/Pacific Islander/Desi American Students Black/African America Students Indigenous (Native American, Alaskan, Hawaiian) Students Multiethnic Students LGBTQ Students Current/Former Foster Youth Students Undocumented & DACA Students International Students Transfer Students Post-traditional/Adult Learners Students Other If you selected other, please share Do you live on campus?(Required) Yes No Languages Spoken Add RemoveUse the "+" sign at the end of the line to add multiple languagesPreferred method of contact (Select all that apply) Skype/Zoom/Facetime In-Person Phone Text Email What’s the #1 thing you would like to get out of your mentorship experience? General career advice & guidance Leadership development Expanding your network Career-related expertise Areas where you hope your mentor to make an impact Knowledge and Practice of Professional Etiquette Focus and Practice on the Field of Career Professional Network Expansion Personality Development Communication Skills Improvement Professional Interest or Expertise If you had to describe yourself (Select all which apply) Enjoys sports Social butterfly Dog lover Health nut Foodie Traveler Techie Outgoing Funny Intuitive Reserved Vibrant Business Lively Passionate Reflected What are a couple of the major challenges you are experiencing and trying to overcome at the moment?Describe your ideal mentor?Explain why you would like to participate in the Mentoring Program?Please list any hobbies, interests, or extracurricular activities?What are your career goals and interest? What are your goals after undergrad?I authorize the verification of the information provided on this form. I give consent for the release of my email information to be used by the Mentor for the duration of the program(Required) Yes No Δ