Mentee Application

1. Contact Information *This question is required.

First Name *This question is required.

Last Name *This question is required.

Email Address *This question is required. This question requires a valid email address.

Cell Phone Number *This question is required.

Alternative Phone Number

3. If you have a resume please upload it here. This is not required, however it's a great opportunity for mentors to learn more about you prior to mentoring day.

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6. If still attending, what is your current grade? *This question is required.

10. Are there any other interests that were missed in the list above?

11. What is your desired job/career goal? *This question is required.

12. What type of job/role would you want your mentor to have? *This question is required.

13. Please describe any reasonable accommodations you may require the day of the event. *This question is required.

15. Food may be served the day of the event, do you have any food allergy/restrictions you would like the company to know about. Please describe.

16. Feel free to use this space to write something about yourself that you would like your mentor to know about you prior to DMD. This should be a professional statement about your career goals and aspirations as opposed to hobbies, personality traits, etc..,

17. If you are completing this application for a potential mentee please provide:

Full Name

Phone Number

Email

Organization

What is your relationship to potential mentee?

Please enter an 'other' value for this selection.

By submitting this application, I affirm that I am at least 18 years old and am my own legal guardian.