Student Profile

Tell us about yourself, your interests, and aspirations

Personal Information

First Name *

Please enter your first name.

Last Name *

Please enter your last name.

Email Address *

Please enter a valid email address.

Phone Number

Date of Birth *

Please select your date of birth.

Gender

Alternative Email Address *

Please enter a valid email address.

Alternative Phone Number

Academic Information

Select Your Career Pathway *

Please select your career pathway.

Student ID *

Please enter your student ID.

Upload a Screenshot of Your Computer *

Please upload a screenshot of your computer.

Mentoring Request Type *

Select Your Current Student Status *

Expected Graduation Year *

Please enter a valid graduation year.

Where did you hear about our program? *

How would you prefer to communicate with your mentor? *

Please select your preferred communication method.

Please share any information that would help us match you or transfer you to a mentor

For about how many consecutive months do you expect to need mentoring? *

Please enter the expected number of months.

Interest & Hobbies Information

Select Your Interests (Choose multiple)

Technology

Sports

Music

Art & Design

Reading

Travel

Photography

Cooking

Gaming

Fitness

Volunteering

Entrepreneurship

Please select your career pathway.

What motivated you to seek a peer mentor? *

Please describe your motivation for seeking a peer mentor.

Please summarize the goals you want to work on with your mentor *

Please enter your goals.

What skills would you like to improve upon / focus on? *

Please specify the skills you want to improve.

Select Preferences for a Mentor *

Please select your preferred communication method.

Need help? Contact info@mentorwise360.com