UNT LISSA Mentor Program
Mentee Application Form Spring 2016
Contact Information
Last Name *
Your answer
First Name *
Your answer
Street Address *
Your answer
City, ST ZIP *
Your answer
Phone *
Your answer
E-mail Address *
Your answer
Additional Information
Have you previously participated in the UNT LISSA Mentor Program? *
Preferred method(s) of mentor/mentee contact *
Select one or more.
Required
Program of study: *
Other degree(s) held:
Your answer
Job title, employer, brief explanation of duties:
Your answer
Are you currently an active member of LISSA? *
Note: to participate as a mentee in the UNT LISSA Mentor program you must be an active UNT Library and Information Science Student Association member. To become an active member please send your EUID to untlissa@gmail.com to join the LISSA Lounge on Blackboard.
It is recommended that at least 3 hours each month or 15 hours for the semester be set aside for interaction specific to the mentoring relationship. Will it be possible for you to provide this time to the program? *
Students are expected to communicate with their assigned mentors about any time conflicts. Please be aware that if you do not communicate with your mentor (i.e. fail to show up for meetings, do not respond to e-mails, etc.) you may be removed from the program and become ineligible for future LISSA Mentor Programs.
To help facilitate an effective mentor/mentee match, briefly respond to the following:
Reason(s) for wanting to participate in the mentor program: *
Your answer
Please provide a brief summary of your relevant experience in LIS (i.e. education, work experience, specialized skills): *
Your answer
Please indicate 1 to 3 areas you would like to focus on in your interactions with a mentor: *
Your answer
Submission
Our Policy: It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender identity, sexual preference, age, or disability.
By checking "Agree" and submitting this form, I affirm that the facts set forth in it are true and complete. I understand that acceptance to the UNT LISSA Mentor Program does not guarantee match with a mentor. *
Required
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