NIRSA Mentee Application
Thank you for your interest in the NIRSA Mentor/Mentee Program. Please take a few minutes to complete the following information.

Your mentor/mentee match is intended to last one year with the option of continuing that partnership or beginning a new mentor/mentee partnership.

If you have any questions, please contact the Student Leadership Team at nirsa-mentor-program@nirsaleaders.org

"Mentors impact eternity because there is no telling where their influence will stop”  -John Maxwell
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First Name *
Last Name *
E-Mail Address *
Phone Number *
Institution *
NIRSA Region *
Position Title *
Program/Area Specialties *
Required
Current Experience Level *
Preference of NIRSA Region in which your Mentor resides. *
Would you prefer a mentor who oversees similar program/area specialties? *
If you would like to request a specific Mentor, please list their name and institution below. *
List 1-3 topics/lessons you hope to learn from this experience. *
Submit
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