WINGS Mentee Application Name (First and Last) UO ID: Date of Birth: Grade Level: Phone: Email: Campus Address: What is your academic Standing? Expected Graduation: Major Minor Have you thought about graduate school or additional educational training? What career would you like to pursue? How familiar are you with this field and would you like to learn more about it? What commitments outside of school do you have? Work/employementOrganized team sportsFamily CommitmentsNoneOther When is a good time for you to participate in this program? (please provide information of your availability) Demographic Information Demographic information is collected statistical and potential matching purposes. For example, if a student requests a mentor of their same gender for cultural reasons, we will use this information to match them in some of these cases. Gender Male Female Transgender Genderqueer Other I identify my sexual orientation as: (i.e. Asexual,Bisexual,Gay,Lesbian,Straight.etc) I identify my identity as: White/Caucasian Hispanic Latino/a African or African American Asian or Asian American Native Hawaiian or Pacific Islander Native American or Alaskan Native Middle Eastern Multi ethnic/racial other (Check all that apply) Please indicate up to 3 of your most important matching preference(s) based on the following,if any? Gender Race Ethnicity Sexual Orientation Interests Major/College Career What clubs/organization are you involved with on/off campus? What kind of opportunities are you looking for outside of the resources that you already know about? ( i.e Job shadow , professional development, networking etc.) How will this mentorship program help you through your academic success? Is there anything else you would like potential mentor to know about you? This form is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
