Mentor Information Form

To confirm your interest in mentoring for the upcoming academic year (2013-2014), please take the time to complete the mentor application form below.

The information provided will help in the mentor/protégé matching process. 

More Information

Pamela Mingle
[email protected]


Contact Information
Document Naming ConventionsPlease title the file using the following format 'LastName_Resume'. Do not include any spaces/special characters in the document name.
Files must be less than 5 MB.
Allowed file types: txt rtf pdf doc docx.
Short Answer
Mentor Relationship and Scheduling
In the attributes listed below, I would rate myself predominantly:
Please check all that apply. Please note the goal is three face to face meetings per semester.
Which of the following aspects of mentoring most interests you?
From 1 to 5 please select aspects of mentoring most interesting to you. 1 being strongly interested and 5 being not interested.