S24 BSSE Mentor Application Form

Question 1

First Name:

Last Name:

Email:

Campus:

Department/Faculty:

Program (if applicable):

I identify as:
(select all that apply)

Please indicate your area(s) of expertise:

Year of experience in your area(s) of expertise:

Please indicate the type of mentoring you are interested in providing (e.g., research guidance, teaching support, career development, etc.):

Please indicate which method you prefer:

Please select which of the following formats you are available to support:

Please indicate the specific days and times you are available for mentoring sessions:

Have you served as a mentor before?

Why do you want to become a mentor with Black Student Support and Engagement?

Please include your Bio below: