MENTEE APPLICATION FORM
Mentoring is a special partnership between two people based on commitment to the mentoring process, com-
mon goals/expectations of the partnership, and mutual trust and respect.

Mentoring is a “get and give” experience with the goal of providing a rich and rewarding experience for both

partners. We ask you to share your information so the program manager can match you in a mentoring relation-
ship. Both you and your recommended mentor will have the opportunity to agree to the pairing before you are

assigned to work together.
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Name *
First and last name
Email Address *
Phone number *
ADDRESS
EDUCATION
Please tell us about your most recent level of education:
School Name
Age/Grade Level
MENTORSHIP PROGRAM INFORMATION
Please tell us about yourself and why you are interested in participating in the DRIVE TO THE MENTORING PROGRAM.
Short Bio (tell us about yourself)
Area of Interest
What are your academic/career goals?
Why do you want to work with a mentor? *
Describe your strongest competencies (i.e., knowledge, skills, and abilities):
Describe the competencies you would like to strengthen working with a mentor:
What are your interests or hobbies?
Submit
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