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First Name:
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Last Name:
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Gender:
I am Female
I am Male
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Job Title:
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Department:
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Office Building and Number:
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Office Phone Number:
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Email Address:
Please indicate your
field of study:
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How many students
would you like to mentor?:
What are your interests
and/or hobbies?:
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Are there any restrictions or
considerations when matching
you with a student?:
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How important to you are
the student's Academic Interests?:
Most Important
Important
Neutral
Not Important
Mostly Not Important
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How important to you are
the student's Career Interests?:
Most Important
Important
Neutral
Not Important
Mostly Not Important
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How important to you are
the student's Interests/Hobbies?:
Most Important
Important
Neutral
Not Important
Mostly Not Important
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How important to you is
the student's Gender?:
Most Important
Important
Neutral
Not Important
Mostly Not Important
Please provide any additional
information you believe we
should know that will be helpful
as we match you with a student.:
Please indicate any workshops
you would be willing to participate
in or facilitate.:
How to talk to your instructor and understand the syllabus
Balancing life responsibilities
Discussion of campus resources
Extra-curricular activities/opportunities
Personal development and planning (time management, study skills)
Resume Writing
Networking
Stress Management
Community Involvement and experiential learning
Self Esteem
Test Anxiety
Are there any other areas
of expertise you can share?:
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