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Congratulations on your acceptance into the program! Please provide us with the following information so that we can pair you with a Triton College faculty or staff member that will assist you throughout the semester. Please be thoughtful about your answers, as we want to make sure that we make the best match for you based on your individual interests and goals.
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| * = Required Field |
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| * First Name: |
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| * Last Name: |
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| * Address: |
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| * City: |
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| State: |
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| * Zip Code: |
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| * Phone Contacts |
| Home: Example: 123-456-7890 |
| Cell: Example: 123-456-7890 |
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| * Email: |
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* Best Way to Contact (Select only one):
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| * Career Goals/Major: |
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How did you find out about TEAM Mentor Program?
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| List Languages in which you are Fluent (Other than English, if any) : |
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* Availability for Mentoring
(Enter Time(s) for, at least, one of the days below) Example: 2PM to 4PM
Monday:
Tuesday:
Wednesday:
Thursday:
Friday:
Saturday:
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* Why are you interested in joining the TEAM program?
(Enter "N/A" if no answer)
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* What topics would you feel comfortable discussing with your mentor?
(Select all that apply)
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* Mentor Gender Preference
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Other Mentor Preference (Check all that might apply OR Leave Unchecked for No Preference)
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| * My Hometown is: |
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* I like to talk about:
(Enter "N/A" if no answer)
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* I am most excited about:
(Enter "N/A" if no answer)
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* I am most apprehensive about:
(Enter "N/A" if no answer)
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* The thing that motivates me most is:
(Enter "N/A" if no answer)
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* Something you should know about me is:
(Enter "N/A" if no answer)
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