LOKA Mentorship Program Sign-Up Form

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LOKA Mentorship Program Sign-Up Form

Please fill out this form if you are interested in being a mentee or mentor. Mentors must be at least a junior in college.

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* Indicates required question

Email *

Your email

Full name *

Your answer

Grade (if post-grad, please enter your age) *

Your answer

Are you signing up to be a mentor or mentee? *

Mentor

Mentee

What is your major or field of career interest (i.e. tech/computer science, healthcare/medicine, business, law, undecided, etc)? *

Your answer

Why do you want to be a mentee/mentor? *

Your answer

Is there anything else you would like us to know? (optional)

Your answer

Send me a copy of my responses.

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