Student Alumni Mentoring (Student)

Student Application

Name: *

800#: *

Age: *

Expected Graduation Year(s): *

On Campus Resident or Commuter: *

Major/Minor(s): *

Email: *

Address: *

City: *

State: *

Zip: *

Home Phone Number (999-999-9999): *

Preferred method of Communication: *

Other student organization involved in?

Personal Hobbies and/or interests:

What do you hope to get out of the program/what can you bring to the program?

What industry/career field(s) are you interested in? (Please list up to three)

Is there criteria you would like to have considered when matching you with a mentor?

*By signing this form, I agree to all terms and conditions of the Student Alumni Mentoring program. I understand that this program requires two evenings a semester and regular communication. I commit to building a mutual relationship with my mentor, to hear about new dreams and challenges, to share my own stories, to respect the difference between us, and provide guidance to the best of my ability.

Signature: (initials) *