Full Name
Date of Birth
Email
Cell Phone:
College or University:
Major:
T-shirt size (pre-shrunk, cotton, unisex): Select SizeSMLXLXXL
In order to match you with students who may request mentors by gender / race / ethnicity / or culture, please answer the following (answering is optional): MaleFemale
I identify as which of the following (may choose more than one): African American / BlackWhite / CaucasianLatino / Latina/Hispanic / Other Spanish SpeakingAsianLGBTQNative American
Tribal Affiliation (if applicable):
Please briefly describe your personality and what type of student that you would work best with:
Please tell us anything else that you would like us to know, including anything else for the sessions that you would be willing to help with (ex. Set up, sign in, clean up, teaching or speaking):
