The Collective Success Network: Sign-up form for Students
Welcome to the Collective Success Network! Thank you for signing up as a student!

The Collective Success Network is building a platform in Philadelphia for professionals and companies to support and mentor college students from disadvantaged backgrounds who may also be the first generation in their family to attend college. This initiative is a collaboration between professionals and students leading local campus organizations for first-generation college students.

Joining this network will give you access to a social support network of diverse caring professionals who have relevant life experience to help you navigate the path forward. Many of the professional founders, mentors, and supporters are professionals who were once lower-income, first-generation college students.

Activities that we plan to organize include: a mentorship program, career development workshops, networking gatherings and other events tailored to the needs, challenges and concerns of college students from disadvantaged backgrounds.

We are currently seeking students to be a part of our steering committee to organize events, implement programs and continue to define key priorities as we are developing the organization. We are also looking to connect with student clubs and organizations where FGLI (first-generation low-income) students are members. Please let us know if you are a member of these clubs and can serve as a liaison/spokesperson.

Our initial goal is to recruit 200 professionals and 200 students to sign up. We plan to formally begin programming in the 2017-2018 calendar year. To learn more about us, please visit our new website: https://collectivesuccess.org

Please fill out this form to join this initiative. We need your input to guide us on where to focus our programming efforts. We will NOT share or sell any personal information with anyone else outside the organization.

Thank you,
Student Co-founders: Feyone La, David Thai, Michael Wong, LanhAnh Ho, NgocAnh Ho, Michael Lam, William Wu, Winnie Chan, Jonathan Delgadillo Lorenzo, Isaiah Washington, Malik Griffin, Adrian Fletcher, and many others.
Professional co-founders: Due Quach, Nancy Li, Joe Slavin, Ji Jun, Larissa Polejaev, Theresa Glinki, Reinetta Williams, Stefan Neubig, Sean Quinn, Shane Nelson, Andrea McCord, Rashanda Freeman, and many others

First Name
Your answer
Last Name
Your answer
Email Address
Your answer
What college/university do you attend?
Your answer
What is your current year in college?
What is your expected graduation date?
Your answer
What is your college major and /or career interest area?
Your answer
In hindsight, what is one thing you wish you had known (or someone told you) before you started college?
Your answer
Do you participate in any programs or student groups that offer career advice, professional development, or social support? If so, please elaborate.
Your answer
What level of participation are you interested in? Please select all that apply.
Required
If you checked a or b above, please provide your phone number:
Your answer
What type(s) of support would you find useful? Please select all that apply.
Are you interested in a mentorship program?
This may involve connecting a professional with a group of students or individually once every other week for an hour or two for 1 semester with option to renew.
Do you have any recommendations or suggestions for future events?
Your answer
How can you help spread the word and invite your friends and classmates to join this network and/or attend programs and events?
Your answer
Demographics
Please answer the following questions so that we may not only better understand the diversity of our membership, but also organize events that are geared to participants.
Where is your hometown? (city, state)
Your answer
Where do you live during the school year?
Dormitory, off-campus, commute, etc.
Required
Please indicate your ethnicity/ethnicities/cultural heritage(s).
e.g. African-American, Native American, Mexican, Puerto Rican, Vietnamese, Chinese, Bosnian, Greek, Pakistani, Nigerian, etc.
Your answer
Please indicate your preferred gender identity.
First-generation status
Socioeconomic status
How did you hear about this initiative?
Your answer
Please use this space to share any additional messages
Your answer
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