Each One Reach One Mentoring Program
Mentee Application
Center for Black Culture   University of Delaware

Application Due: Monday, July 18, 2011

    days left to apply to be a Mentee for 2011-2012

 

   *  required fields

* Name:   

Mailing Address:    

* Street:  

* City:   

* State: *  Zip:

* Home phone:  

* Cell phone:

* E-mail:  

* Major:

* Date of Birth

* Race/Ethnicity:

*Please check those that apply:
FRESHMAN TRANSFER   FEMALE MALE

*My Hobbies include:

*Is there any specific information about yourself that would help us
in matching you with a mentor?

* Please rank your preferences for mentor pairing:

Male     Female   Same Hometown    

  Same Major    Same Hobbies  Same Interests  

Anyone

 

* Are there specific characteristics in a mentor that you would want us to consider?

 

*What do you want to receive from your mentor?  Check all that apply:

Tutoring/Academic Support     Time Management     

Campus Resource                  Social Support     

Other (Special Skill)  

 

* My expectation of the mentee experience is:

* My expectation of the mentor is:

 

* T-Shirt Size:   S      M     L      XL   2XL   

 

 *  Date

 

 

Please return form to:


THE CENTER FOR BLACK CULTURE
192 S. COLLEGE AVE.


NEWARK, DE 19716

ATTN: EACH ONE REACH ONE PROGRAM MANAGER

Deadline to return this application is Monday, July 18th

Any questions or concerns about the program should be addressed to

the Program Manager at the Center for Black Culture at (302) 831-2991.