Clark College First Year Experience (FYE)

The following information will be used to match mentees with staff/faculty mentors. Please complete this interest form and submit it. We will follow up with you shortly.

Contact information and interests will be shared with your mentor.

Name:

Last

First

M.I.


Contact:

Primary #   

Alternate #

Email            


Gender Identity
Male
Female

We will make the best effort to match mentees with a mentor of the same gender identity. However, this may not always be possible. What are your preferences in finding a mentor match for you?
Male
Female
No Preference


Supplemental Questions

What is your preferred form of communication?


What is your intended area of study?


Why are you interested and/or what do you hope to gain from having a mentor at Clark College?


What are your hobbies, special skills, or other interests?


(Optional) Is there any additional information you'd like to share? (e.g. work history, unique life experiences , demographic identity groups; e.g. student of color, LGBTQ, differently abled, veteran, non-traditional aged student, etc.)


Are you able to attend a mentee orientation and meet & greet social on : Friday, April 4, 2014, 1:00 - 3:00 p.m. at Clark College's Main Campus?

Yes
No




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