menteeApplication (PDF)
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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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