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Mentee Application

Wait! Have you identified three potential mentors? If not, please go to:
Find a Mentor

Mentee Application Form

All fields required. (Enter "N/A" if not applicable.)

Last Name


First Name


Preferred or Nickname


Address


City State Zip
      

Preferred Phone


Preferred Email


Confirm Email


Degree
in

Occupation (current and/or desired)


Field of Interest


Number of Monthly Hours Preferred
We ask mentors for minimum 1 hour per month


Top Mentor Choice


Second Mentor Choice


Third Mentor Choice


*If your top three mentor choices are unavailable, we will try our best to connect you with a different mentor that suits your needs.



Are you a Marylhurst student?
Yes       No

Are you a Marylhurst alum?
Yes       No

Are you the first in your family to graduate from Marylhurst?
Yes       No

How did you hear about the mentor program?


Profile Information
Your profile information will be shared with your chosen mentor(s).

Job Description
e.g., I work as an independent consultant, transcribing interviews.


Services Desired
e.g., Big picture career brainstorming, strategic planning and skills assessment.


Hobbies
e.g., I enjoy lazy weekends with my dog, reading, watching movies and gardening.


Proud/Recent Accomplishment
e.g., Negotiating a membership scholarship program for a civic club.


Goals & Ambitions
e.g., To develop my entrepreneur skills and establish a non-profit organization.


Demographics - Optional
The following questions are optional. We appreciate your responses. They are reported as aggregate results when the Mentor Program seeks grants and other funding.

Gender
Male       Female

Age


Ethnicity

Questions? Contact the Program Coordinator.




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Marylhurst University
17600 Pacific Highway (Hwy 43) / PO Box 261 / Marylhurst, OR 97036-0261
Phone: 503.636.8141 / Toll-free: 800.634.9982 / Fax: 503.636.9526