Connect Faculty-Student Mentorship Program Enrollment Form Fall 2023/Spring 2024
Complete the enrollment form to secure your spot in the Fall 2023/Spring 2024 Connect Mentorship Program. Students will work with faculty mentors in their departments to receive guidance and advice on the college and post-grad journey. 
Sign in to Google to save your progress. Learn more
First and Last Name
Pronouns (Examples include she/hers, he/his, they/them, etc.)
UIC Email
Do you identify as a first-generation college student (neither parent nor guardian has graduated from a 4-year college located in the United States with a bachelor's degree)?
Clear selection
What is your LAS major? 
If you are on a pre-professional track (such as pre-nursing or pre-med) or an interdisciplinary field (such as integrated health sciences or neuroscience), please indicate what LAS department you would like your faculty mentor to be in.
What is your class year?
Clear selection
Have you previously participated in the Connect Program?
Clear selection
Welcome Session
All Connect Students are invited to attend a Welcome Session. During the session, you will learn important program details and identify goals to work toward with your faculty mentor. Food and beverages will be provided. Please note that you only have to attend one Welcome Session. If the options do not work with your schedule, you will have an opportunity to meet with First-at-LAS on a different day. 
Please select one Welcome Session you plan to attend.
Clear selection
If you are unable to participate in one of the Welcome Sessions, please share your availability and First-at-LAS will contact you to schedule a meeting. Example: Mondays, Wednesdays, and Fridays before 3 PM. 
Save the date!
The Connect Program will host a Networking Event for all student and faculty participants. Please save the date to meet others in the program and enjoy food and beverages!

Connect Program Networking Event: Wednesday, September 13, 3-5 PM (Drop-in anytime and stay as long as you can!), Daley Library, Room 1-470 
Thank you for enrolling! 
We will contact you with a reminder about the Welcome Session. In the meantime, please reach out to first-at-las@uic.edu with any questions or concerns. 
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of University of Illinois Chicago. Report Abuse