Student Profile

Tell us about yourself, your interests, and aspirations

Personal Information

First Name *

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Last Name *

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Email Address *

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Phone Number

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Date of Birth *

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Gender

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Alternative Email Address

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Alternative Phone Number

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Academic Information

Select Your Career Pathway *

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Student ID *

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Upload a Screenshot of Your Computer

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Mentoring Request Type *

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Select Your Current Student Status *

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Expected Graduation Year *

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Where did you hear about our program? *

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How would you prefer to communicate with your mentor? *

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

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

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Interest & Hobbies Information

Select Your Interests (Choose multiple)

Technology

Sports

Music

Art & Design

Reading

Travel

Photography

Cooking

Gaming

Fitness

Volunteering

Entrepreneurship

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What motivated you to seek a peer mentor? *

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

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

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Select Preferences for a Mentor *

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Need help? Contact info@mentorwise360.com