PNMGC Peer Mentoring Program


Mentee Application


Basic Information
* First Name
* Last Name
Mentee Contact Information
* Email
* Confirm Email
Mobile Phone
* Phone
Demographic Information
Date of Birth
Sexual Orientation
Ethnicity
Ethnicity Other
Primary Language
Primary Language Other
Education Information
* Year in college
* Major Field(s) of Study
Major Field(s) of Study Other
Graduate Degree(s) Anticipated
Graduate Degree(s) Anticipated Other
Degree Candidacy Type
Employment Information
* Anticipated Profession
* Anticipated Profession Other
Involvement with outside organizations
Other Information
Hobbies
Hobbies Other
Career Focused Interests
Career Focused Interests Other
Skills I want to improve upon
Student ID Number
What would you like to be matched on?
Program questions
What is your country of origin?
What are your expectations for the peer mentoring program?
Your Gender
* What is your preferred availability?
* Have you previously participated in a Peer Mentoring Program?
* Is there a specific person you would like to be matched with?
If you have a specific request, please provide their name.
* I am...

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