JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Mentee Questionnaire
* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Preferred First Name
Your answer
Permanent Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Phone Number
*
Your answer
Ethnicity
*
African-American
Hispanic
Caucasian
Native American
Asian/Pacific Islander
Multi-Racial
Other:
Primary Language
*
Your answer
Secondary Language(s)
Your answer
Gender Identity
*
Male
Female
Other:
University, College, and/or Technical School Planning to Attend
*
Your answer
Planned Major(s)
*
Your answer
Career Goal
*
Your answer
Are you a first-generation college student?
Yes
No
Unsure
Clear selection
Are you the first person in your immediate family to attend a college and/or university?
*
Yes
No
Which areas are most important for you and your mentor to have in common? List these options in order from highest priority to least: gender, college/trade school attended, major, career field (if you have no preference, respond N/A).
*
Your answer
What are some of your interests and hobbies?
*
Your answer
What are some of your short term goals?
*
Your answer
What are some of your long term goals?
*
Your answer
By clicking "I Agree," you understand that your mentor is here to help you be successful during your first year of college, so it is important that you be open & responsive to them.
*
I agree
A copy of your responses will be emailed to the address you provided.
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
