JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Centralia College Alumni Mentorship Program
Thank you for considering being a mentor! Please answer the following based on your ability and willingness to mentor on the given subject(s).
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Name:
*
Your answer
Phone Number
*
Your answer
Current Employer:
*
Your answer
Title:
*
Your answer
Where are you located?
*
Lewis County
Thurston County
Pierce County
Cowlitz County
Pacific County
Other:
How would you prefer a mentee to interact with you?
Email
Phone
In Person
Which of the following programs would you be the best mentor for?
*
Business
Finance
Natural Science (Biology, Chemistry, Environmental Science)
Technical Sciences (IT, Computer Science, Math, Physics, Electronics)
Social Studies (History, Politics, Economics)
Trades (Diesel Tech, Welding, Electronics)
Healthcare
Teaching/Education
English, Foreign Language
Arts
Other:
Required
Please list other colleges where you earned a degree, and type of degree.
Your answer
Would you be willing to advise on one of the following special needs or interests?
Single Parent
Minority Groups (women, people of color, disabilities, etc)
Spanish Speaking
Mid-Life Career Changes
Additional Degrees (BA/BS. Masters, PHd, MD, etc)
Other:
Would you be willing to attend alumni networking events?
*
Yes
No
Questions? Comments? Concerns? Let us know!
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report
