QWiSE Mentorship Program
Undergraduate Participant: Application Form
What is your name (first and last)? *
Your answer
How do you wish to be involved in the QWiSE Mentorship Program? (please note that the mentor option would be for our high school program) *
Which of the following interests you after graduation? *
Tell us a bit about yourself! What field of study are you currently pursuing and why did you choose this program? Please be detailed in response: *
Your answer
What are some of your current career goals and/or aspirations? How do you wish to achieve them? *
Your answer
Why do you wish to be a part of the WiSE mentorship program? What value do you see in mentorship? *
Your answer
Please select all forms of contact in which you are open to have with a mentee/mentor below: *
Required
Please describe your availability and preferred form of contact with mentees or mentors below (i.e. 1 hour a week through video chat, in person, phone or all of the above). *
Your answer
Please provide us with your contact information (email and phone number) below: *
Your answer
If available, please provide us with a link to your LinkedIn profile to aid in creating your WiSE portfolio.
Your answer
Finally, what are some of your personal interests, projects and/or hobbies? *
Your answer
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