College Mentoring Program Intake Form
Thank you for your interest in becoming a College Mentor with one of our EVkids college students. Below are a few questions to better equip ourselves for mentorship pairing and interactions.
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Full name *
Phonetic Name Pronunciation
Please spell your first and last name phonetically. For example, ‘Ska-hot Pie-zick’ for Scott Pyzik
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Race/Ethnicity *
College/Year Graduated/Major(s)/Degree Type *
Current graduate school and major (if currently enrolled)
Current employment and job title *
Street Address *
City *
State/Province *
Country *
Zip/Postal Code *
Phone number *
Email *
Best way to contact about scheduling check-ins or sharing quick information with the College Success Advisor (emails will be sent for resources/detailed information, calls for check-in's) *
Best days with EST times to check-in with the College Success Advisor throughout the year (if this changes at any point in the year, let us know):
Monday
Tuesday
Wednesday
Thursday
Friday
10am-10:30am
10:30am-11am
11am-11:30am
11:30am-12pm
12pm-12:30pm
12:30pm-1pm
1pm-1:30pm
1:30pm-2pm
2pm-2:30pm
2:30pm-3pm
3pm-3:30pm
3:30pm-4pm
4pm-4:30pm
4:30pm-5pm
5pm-5:30pm
5:30pm-6pm
6pm-6:30pm
6:30pm-7pm
7pm-7:30pm
7:30pm-8pm
8pm-8:30pm
8:30pm-9pm
Previous tutee(s) name(s), if any:
Is there anything else you would like your possible mentee to know about you?
Any other questions or comments?
After selecting 'Submit', an enrollment application will be sent to the supplied email address. Someone will reach out soon to talk more about the College Mentoring Program and next steps to become involved.
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