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GPS Mentor Intake Form
We are always looking for GPS team members to provide guidance, perspective, and support to students who are exploring their sexuality orientation, gender identity or gender expression.

In order to be a mentor for GPS you must:
*complete the GPS Mentor Intake Form (that's this one!)
*Attend a mentor training.

If you have any questions, please email evestal@umich.edu

Name
Your answer
Affiliation
If you're a student: Year & School
Your answer
Major/Concentration/Field
Your answer
Email
Your answer
Age
Your answer
Please list any hobbies or interests you have.
Your answer
Please list any clubs or organizations in which you are involved on campus.
e.g. Greek Life, student organizations, internships, etc.
Your answer
Have you been a GPS mentor before?
Do you participate in any other Spectrum Center Programs? If so, which programs?
Your answer
Demographic Information
We collect this data to better match you with a potential mentee. It will not be shared or distributed outside of the GPS program.
How you do identify your sexual orientation or attractionality?
Your answer
How you do identify your gender?
Identity and/or expression
Your answer
What pronouns do you use?
Your answer
What is your racial identity?
Your answer
What is your ethnic background?
Your answer
What is your religious background?
Your answer
What is your current religious interest or identity?
How important is this identity to you?
Your answer
Please list any other identities that are significant to you
200 words or less
Your answer
I am out to...
Check all that apply
Required
I am comfortable discussing...
Check all that apply.
Required
Mentor Information
Why are you interested in mentoring through the GPS program?
200 words or less.
Your answer
Are you interested in having long-term or one-time mentorship commitments?
I am comfortable communicating with a mentee through...
Required
What skills, experience, and knowledge can you bring to this program?
200 words or less.
Your answer
Briefly describe a significant experience from your own life relating to your gender and/or attractionality. What did you learn about yourself and others during this process?
200 words or less.
Your answer
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