Mentee Information Form
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Full Name: *
Preferred first name:
Institution: *
Job Title: *
Number of years in current position: *
Street Address: *
City: *
State: *
Zip Code: *
Preferred Phone Number: *
Preferred Email Address: *
Gender: *
What accrediting agency(ies) is you institution under? *
Number of Students (FTE)? *
Educational programs you currently serve (check all that apply) *
Are you a Solo Librarian? *
Position(s) you currently hold: *
Why would you like to have a mentor? What are your goals for this relationship? *
What are some of your hobbies or interests? *
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