SAM Application SAM ApplicationFields marked with an * are requiredPlease enable JavaScript in your browser to complete this form.Please choose from the following options: *New Mentee (Student)Returning Mentee (Student)New Mentor (Alumni)Returning Mentor (Alumni)Have you previously participated in the SAM program? *YesNoMaybeHow did you hear about SAM? *Select OneParticipated previouslyCurrent studentFacultyAlumniSocial mediaE-mailFlyerOtherOther- please explain! *Has any of your information changed from last year? *YesNoName *FirstLastAge *Graduation Year(s) *Student Level *Select OneFreshmanSophomoreJuniorSeniorGraduateMajor(s) *Select OneFreshmanSophomoreJuniorSeniorMajor/Minor(s) *Preferred Method of Communication *Email *Phone *Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeCurrent Industry *Years of Experience *Company Name *Current Position/Title *Past Positions *List company/title and dates employed for each.How did you hear about SAM? (Select all that apply.) *Past participantAlum friendCurrent studentFacultySocial mediaEmailMailerOtherIf you selected "other" above, please explain.Other Business/Organization Affiliations *Please provide a brief description of your community/civic engagement: *Personal hobbies and/or interests: *Briefly explain why you are interested in becoming a mentor and your expectations of the program: *Are you interested in providing job shadowing opportunities for current USF students? *YesNoMaybeStudent organizations, volunteer organizations or internship involvement: *What do you hope to gain from the program? *What can you bring to the program? *What industry/field are you interested in? (Please list up to three) *Is there criteria you would like to have considered when matching you with a mentor? *Mentor Agreement *By submitting this form, I agree to all terms and conditions of the Student Alumni Mentoring program. I understand that this program requires one evening per semester and regular communication with my mentee. I understand that attendance at the Induction Reception on November 3, 2022 is mandatory for participation. I commit to working to build a mutual relationship with my mentee, being open to new dreams and challenges, to share my own stories, to respect the difference between my mentee and me, and to provide guidance to the best of my ability. If at any time I feel I cannot continue in the program, I will notify both my mentee and the Alumni & Family Relations Office.Mentee Agreement *By submitting this form, I agree to all terms and conditions of the Student Alumni Mentoring program. I understand that this program requires one evening per semester and regular communication. I understand that attendance at the Induction Reception on November 3, 2022 is mandatory for participation. I commit to to building a mutual relationship with my mentor, to hearing about professional experiences, to sharing my own stories, to respect the difference between my mentor and me, and to accept guidance to the best of my ability. If at any time I feel I cannot continue in the program, I will notify both my mentor and the Alumni & Family Relations Office. EmailSubmit
