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Career Mentoring Program Student Interest Form
*required fields

Campus Address
Phone #
Current Class Standing

Check all that apply:
  TRADITIONAL STUDENT (Full-time student enrolled in 12+ credit hours per semester)
COMMUTER (Living off campus)
WORKING STUDENT (Full-time job & part-time student enrolled in <12 credit hours per semester)

Please list the career field for which you want a mentor (e.g. "marketing/retail," "social work/case worker"). If you have interest in several fields, list them in order of priority.


Do you prefer a male or female mentor?

Where do you wish to live in the future (country, state or region)?
Please list any experience you have with your career field (e.g., internships, job shadowing, jobs, etc.)
*Briefly describe 1) your career goals/academic plans and 2) why you want to participate/what you hope to gain from the Career Mentoring Program
(250-word limit)
*I am aware of the expectations of the program and am prepared to give at least 1 hour each month to the Career Mentoring Program.

*You may share my contact information and application form with my career mentor.

*Type your name in the box below to serve as your electronic signature

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