menteeApplication .pdf

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Original filename: menteeApplication.pdf
Title: Microsoft Word - Mentee Application_(NAME).docx
Author: Anita Ting

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FRESHMEN  MENTORING  PROGRAM  
 
 

Basic  Information    
Name:  ________________________________________  
Major:  ________________________________________  
Graduation  Year:  ________________________________  
Email:  _________________________________________                Telephone:  _________________________    
Class  Status:           Freshmen    

 

Program:    

 

4yr/  1  Co-­‐op    

 

5yr/  3Co-­‐op  

National  Member:    

 

Yes    

 

No    

Co-­‐op  Cycle:      

 

Fall/Winter  

 

Spring/Summer    

 

Transfer    

 

Interested  in  Other  Degrees/Career  Interests:  
     
Minor:    _________________________________________  
 
Bs/Ms:  _________________________________________  
 
Pre-­‐Med/Pre-­‐Health:  ______________________________  
 
Others:  _________________________________________  

 

 
Jobs/Co-­‐ops  Interested:    






 

Co-­‐op    
Company’s  Name:    ___________________________________________  
Position:    ___________________________________________________  
Internship  
Company’s  Name:    ___________________________________________  
Position:    ___________________________________________________  
Are  you  a  STAR  Scholar:      
Yes      
 
No  
Project:  _____________________________________________________  
Department:    _________________________________________________  
Position:    ____________________________________________________  
On-­‐campus/Off-­‐campus:  ________________________________________  

Special  Interests  and  Achievements:  
Are  you  interested  in  Study  Abroad:      
Yes      
 
No  
Country/University  preference:  ____________________________________________________  
Year/Term  you  want  to  go:  ________________________________________________________    
 
Are  you  interested  in  Co-­‐op  Abroad:      
Yes      
 
No  
Country/Company  preference:  ____________________________________________________    
Year/Term  you  want  to  go:  _________________________________________________________  
   
Are  you  in  Engineering  Learning  Community  (ELC):    

Yes    

 

 

No  

 
What  is  your  career  interest:  
_____________________________________________________________________________________
_____________________________________________________________________________________  
 
What  activities  were  you  involve  in  High  School:  
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________  
 
Other  Interests/Hobbies:  
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________  


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