Community Mentorship Network – Mentor Interest Questionnaire

Thank you for your interest in mentoring a student through the Community Collaborative Mentorship Network! This program connects professionals with motivated high school and college students seeking career or academic exploration, applied work, or research experience.

Please complete this form so we can understand your background, availability, and level of involvement.

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First Name
Last Name
Email Address
Phone Number
Home Address
Company/Organization Name
Work Address
Current Job Title/Role
What is your highest level of education?
Clear selection
What field(s) did you study in college or graduate school?
Briefly describe your professional background and work experience or share a link to your LinkedIn profile, article, or website detailing your background.
We all have experience in industries or fields that would beneficial for a student to learn about. Indicate which area(s) best describe your experience.
Why are you interested in becoming a mentor in this program?
What type/area(s) of student interests align with your expertise?
What level of involvement are you open to considering? (select all that apply)
What time of year are you available to mentor a student?
Clear selection
Are there any additional details you'd like to share about your mentoring availability or preferences? 
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