Harmony College & Career Mentor (CCM) Application Form
Hi Harmony Alum!
Harmony College & Career Mentoring program aims to connect current Harmony high school junior/senior or college freshmen students with Harmony College & Career Mentors to help them navigate the college and career success. Please answer the questions below if you wish to be a mentor! If you have any questions or need assistance in filling out or submitting this form, please contact your campus College & Career Success advisor or email to
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What is your first name?
What is your last name?
What is your gender?
Which Harmony Mentoring Program do you sign up for? (Select any you are interested in)
College and Career Mentoring for High School Juniors/Seniors
College and Career Mentoring for College Freshmen
What is your race/ethnicity?
Please select all that apply.
Native American/Alaska Native
What is your college e-mail?
Please list your college email address where you can best be reached.
What is your personal e-mail?
Please list your personal email address where you can best be reached.
What is your phone number?
Please list the phone number where you can best be reached.
Which Harmony high school did you go to?
Please select your Harmony high school.
HSA-Pflugerville (Formerly HSA-North Austin)
What year did you graduate from Harmony high school?
What college do you currently attend or graduated from?
When do you plan on graduating or graduated from college?
Please list the full year (i.e. 2020)
Are you interested in a young professional guiding you through the process of finding internships and securing a job in your major?
What degree are you currently seeking?
Please select from the following options.
Communications (Journalism, Public Relations)
Arts (Music, Dance, Graphic Design, Film)
Social Science (Psychology, Sociology, Anthropology)
Humanities (English, History, Languages)
What are your plans after college?
Tell us about yourself and why you want to be a College & Career Mentor for high school juniors and seniors!
In 5-6 sentences at the very least, give us a bio.
Do you understand the time commitment?
Yes, I understand this is a commitment of at least 30 min per week.
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This form was created inside of Harmony Public Schools.