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Mentor Application 2022-2023
Mentor Application 2022
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Email
Your answer
First Name
Your answer
Last Name
Your answer
Gender
Male
Female
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Cell Phone #
Your answer
Work Phone #
Your answer
Mentor's Organization/Company Name
Your answer
Mailing Address
Your answer
Career Field
Programming
Cyber Security
Entrepreneurship
Other:
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Are you a BCHS/NSITE Alumni
Yes
No
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Mentor Status
New
Returning Mentor
NOT RETURNING
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How many years have you been a Mentor?
Your answer
Would you like to stay with the same mentee?
Yes
No, my student graduated
New mentor - haven't been assigned
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Tell us about yourself. Career field, interest, goals
Your answer
Why do you want to be part of the Mentor Program?
Your answer
Name of your mentee (returning mentors)
Your answer
Preferred day to meet with your mentee
Thursday
Friday
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Submit
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