Physical Sciences Mentorship Program Application - Winter 2024
Application for Mentors

Winter Quarter Mentorship Program Details:

Program Dates: January 8th, 2024 to June 7th, 2024
Time Commitment: Mentees and mentors are encouraged to meet at least once a month for 30 minutes or more. 
Format: In-person and/or virtual meetings with your mentee.
Purpose: To provide career guidance, share insights, and support personal and professional development for our students.

Your role as a mentor is incredibly valuable, and here's what you can expect:

  1. Meaningful Connections: Forge relationships with motivated and talented students eager to learn from your experiences.

  2. Personal Growth: Refine your mentoring and leadership skills while making a lasting impact on a student's life.

  3. Networking Opportunities: Connect with other dedicated mentors and professionals in our network.


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First Name *
Last Name *
Email address *
Salutation *
Mr., Mrs., Ms., etc.
Phone *
Location *
LinkedIn URL
Gender (optional)
Race/Ethnicity (optional)
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Highest Degree Level Achieved *
What was you college major? What degree(s) do you have? *
UC San Diego Alumn? *
First Generation College Student *
Have you participated in the Physical Sciences Mentorship Program in the past? *
Where do you currently work? *
What is your professional job title? *
How many students are you able to mentor *
Do you prefer to work with students from certain major(s)? *
Required
Do you know what degree level your company is interested in for INTERNSHIP opportunities? *
Required
Do you know what degree level your company is interested in for FULL-TIME EMPLOYMENT opportunities? *
Required
I can provide mentoring to students on the following topics *
Required
Is there anything else you would like us to consider?
Type your full name if you have read the Winter 2024 Mentor-Mentee Agreement: https://docs.google.com/document/d/1RCvAgntHQvbcF-tDNbzQ7dM5QqHufdso/edit?usp=sharing&ouid=102927167768625810737&rtpof=true&sd=true *
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