Collegiate Connection Mentor Request Form
We are excited to connect you with one of our Collegiate Connection Mentors! In order for us to connect you, first we'll need a little bit of information about you and your goals. The more information you provide, the better we can pair you.
Name *
Your answer
Email: *
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Phone: *
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Best method of contact: *
Your answer
Date of Birth (mm/dd/yy) *
Your answer
College/University *
Your answer
College Major *
Your answer
Class standing (freshman, sophomore, etc.) *
Your answer
Student Involvement *
Your answer
Interests/Hobbies *
Your answer
Employment/Internship *
Your answer
Geographical Location (state) *
Your answer
What are your professionals goals? *
Your answer
What are your immediate concerns regarding academic and professional development? *
Your answer
What are your expectations of a mentor? *
Your answer
Do you identify as an introvert or extrovert? *
Your answer
What additional information should we know about you that will be helpful in pairing you with a mentor?
Your answer
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