Connections* Intake Form!
Email *
About You
What is your name? *
What are your gender pronouns? *
What is your year in school? *
If you would like us to reach you by phone, what number should we use?
This will not be shared with your mentor.
What identities do you hold?
This is completely optional. Labels are yours to have, not have, and disclose when you want.
Your Connection
What brought you to Connections*? *
What would you like to talk/connect about? How can we support you? *
Do you have any special requests for your mentor? *
What do you need from a mentor? What qualities or identities can you relate with in a mentor?
What has been the best part of your week so far?
What's a fun fact or hobby we can tell your mentor?
This is a reminder to fill out the whenisgood on the next page so you can be connected! *
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