Expo! Expo! Mentee Application Form

* Required Fields

First Name*

Last Name*

Your Email*

Please select your gender:

Are you a student?



Expected graduation date:



Years in the Industry

Year Born (yyyy)

Are you willing to connect prior to Expo! Expo!?

Primary Address

Primary Phone Number

Alternate Phone Number

How would you prefer to communicate with your mentor? (Ctrl click to select multiple)

Any additional details regarding your communication preference:

Educational background (degrees, majors, student activities):

1. What are your areas of interest?

2. What do you hope to gain from this experience?

3. Who is your role model? Please give a brief description of who they are and how they inspire you.

4. In what ways do you think a mentor could help you? (Ctrl click to select multiple)

If you selected other in the previous question, what additional way(s) do you feel a mentor could help you:

Other comments or questions?