Mentee Application Form

Please complete the form below, and we'll do our best to match you with a compatible mentee. Please share only the information you are comfortable providing.

Required Field
Personal Information
First Name:
Last Name:
Student ID:
School:
Program:
Semester:
Phone:
E-mail:
Questionnaire

1. I prefer to be matched with a mentee who is:
Male Female No Preference

2. I prefer to be matched with a mentee who is:
Traditionally Aged Student Mature Student (22+) No Preference

3. I prefer to be matched with a mentee who is:
Quiet/A Bit Reserved Outgoing No Preference

4. What is your primary reason for seeking a mentee?

Please note:
All information requested by the MI Mentoring Program will be used solely for the administration and management of the program. Personal information is collected under the authority of the Memorial University Act (RSNL 1990 Chapter M-7) and is used for the purposes of academic administration and program planning. Questions about this collection and use of personal information may be directed to Student Affairs at 709-778-0702.

  I agree to the above terms