GRASE LGBTQIA+ Mentorship Program: Mentor form
We are excited that you are interested in the Center for Gender Resources and Sexual Education (GRASE) Mentorship Program. 

This is a pilot program aims to enhance LGBTQ+ students’ overall college experience by matching students with alumni mentors for guidance, support, and resources. The goal of the program is to cultivate a meaningful and supportive college environment for LGBTQIA+ students to thrive personally, academically, and professionally.

Mentors will be required to meet with GRASE staff to discuss expectation of the program, confidentiality, boundary, and resources.

Please note: The Mentorship Program is not intended to take the place of professional counseling, but rather to be an additional or alternative option for students seeking mentorship.


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Full Name *
Pronouns *
Email Address *
Class Year *
Geographic Region: *
Why are you interested in serving as a mentor? *
What are your hobbies and interests? *
What is your preferred method of communication? *
How much time do you see yourself being able to give to this program during the year? *
How many student mentees do you prefer to work with during this academic year? *
What is a potential challenge you foresee in entering this mentoring relationship? *
Please submit a brief bio about yourself. *
Please share anything you would like to be considered when being matched with a mentee. *
Demographic Information
Please share as much information as you are comfortable submitting, as it will be helpful for matching mentees who may request mentor with specific identities or background. If you choose to not enter the information, please write "N/A". Answers to the following questions does not impact your eligibility in the program.
Gender Identity *
Sexual and/or Romantic Identity *
Racial and Ethnic Identity *
Religious/Spiritual Affiliations *
Other identities you wish to be considered *
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