LGBTQ Mentorship Program: Application for Prospective Students
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Year in School
Date of Birth
Racial/Ethnic Background(s) with which you identify
Arab/Middle Eastern American
Native American/Alaska Native/Pacific Islander
Country of Origin
Opposite sex relationship
Religious/Spiritual Ideology (if any)
What brings you to the Mentoring Program?
What are some of your interests in coming to Dickinson?
What are some of your educational/professional goals/interests?
What would you like to learn about Dickinson and LGBTQ life?
How did you hear about the Mentoring Program?
What involvement, if any, do you have with the LGBTQ community?
DISCLAIMER: The Program attempts to match mentees with mentors based on similarities in characteristics, such as sexual orientation, gender, interests, and race/ethnicity. In the event that a mentor with the same characteristics as yours is not available, the program will match you with the person who is most similar to you. If you have any comments, wish to add any additional information, or have any preferences for a type of mentor, please note them here. You are strongly encouraged to list those traits which are important to you for your mentor to share (i.e. ethnicity, religion, etc.).
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