Men As Leaders Empowered to Strive (MALES)
Mentor Program Application
Last Name *
Your answer
First Name *
Your answer
NSCC Student Email (@northshore.edu) *
Your answer
Personal Email *
Your answer
Date of Birth (Month/Day/Year) *
Your answer
Address *
Your answer
Cell Phone *
Your answer
Home Phone *
Your answer
Ethnicity: Hispanic/Latino *
Race *
What is your primary language?
Your answer
Do you plan to attend: *
Do you plan to take courses during the: *
Do you plan to take online and/or hybrid courses? *
Which campus/campuses are your classes? *
Required
Please describe your career goals? *
Your answer
During the FIRST THREE WEEKS of your FIRST SEMESTER/QUARTER at NSCC, about how many hours do you expect to spend in a typical 7-day week doing each of the following? *
None
1-5
6-10
11-20
21-30
More than 30
Preparing for class (in a typical 7-day week)
Working for pay (in a typical 7-day week)
What do you consider your academic strengths? - check all that apply.
How would you describe your computer literacy skills? *
List your hobbies and interests. *
Your answer
In 50 words or less, tell us why you are interested in becoming a member of MALES?
Your answer
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