KAA Mentorship Mentor Application (2014-2015)

The Khmer Alumni Association Mentorship Program pairs up a mentee with a mentor from January to June 2015. Throughout this relationship, there will be contact via remote session at least once a month to discuss any questions, comments, or concerns regarding academics, career choices, or any life decisions.


The purpose of KAA ‘s Mentorship Program is to provide one-on-one guidance and support for Cambodian students. By doing so, KAA aims to promote enriching knowledge, professional development, experience and relationships that will help empower Cambodian students to succeed in their academic/career success, individual goals and lives thereafter.

Mentors and Mentees

Mentors are members of the Khmer Alumni Association who have filled out an application. After completing the application, the committee leads will notify mentors and have them go through a training session. Mentees are high school students who have filled out an application, which includes a parent/guardian consent form. Upon submitting the application, a screening process will take place and a selected group of mentees will be invited to attend orientation. Afterwards, the committee leads will notify mentees and mentors of their pairing beginning January 17th.

Any adult may apply for the KAA Mentorship Program, if you:

Graduated from a 4-year accredited college/university
At least 22 years-old
Bachelor’s degree or higher
Member of Khmer Alumni Association
Interested in helping students clarify, explore and learn about their academic/career goals
Are enthusiastic about the program and the opportunity to provide guidance and support
Internet access and computer with built-in camera
Complete and submit KAA Mentorship Program Mentor Application by December 31st
Complete and submit KAA Mentorship Program Mentor Agreement by January 17th
Attend 1 Training Day on Saturday, January 17th OR January 24th

Name *
First and Last name format
Your answer
Gender *
Address *
Street, City/Town, Zip Code
Your answer
Home Phone Number *
Your answer
Cell Phone Number
Your answer
Birthdate *
MM/DD/YY format
Your answer
E-Mail *
Your answer
Age *
Your answer
What language(s) do you speak? *
Your answer
Highest Level of Education *
Degree and specialization please
Your answer
School Name *
Your answer
Favorite Subject *
Your answer
LEAST Favorite Subject *
Your answer
What activities, sports, clubs, etc. are you involved in? *
Your answer
I would describe myself as... *
Please choose three
What is your current profession? *
Your answer
What other professions/jobs did you have before your current one? *
Your answer
Please tell us what you hope to gain from this mentorship program. *
For example: build new relationships, learn what to expect in college, how to do better in school, explore new careers, gain new career/college goals
Your answer
Have you ever had any related experience as a mentor before? *
If you answered 'YES' to the question above, please explain your related experience as a mentor.
Your answer
How would you describe your involvement with KAA? *
What do you like to do the most in your free time? *
(Check all that apply and give examples of your favorites)
Please introduce yourself to your mentee by writing a little bit about yourself. You can start by telling them your name, how old you are, where you live and what you expect to gain from this experience. Also let them know what your career plans are, how the journey has been, what college or university you attended, and why you think being a mentor is important, especially in the Cambodian-American community. *
Your answer
Which day will you be available to attend Orientation? *
(Please choose one date)
How did you learn about KAA Mentorship Program? *
For example: friends, social media, website, event
Your answer
Is there any additional information or comments that you would like to add?
Your answer
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