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* 1. First Name

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* 2. Last Name

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* 3. Preferred Pronouns

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* 4. email address

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* 5. Mobile phone

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* 6. LinkedIn Profile URL (if none, indicate so)

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* 7. Parent First Name

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* 8. Parent Last Name

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* 9. Parent email address

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* 10. Your High School Name

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* 11. Your Year of Graduation

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* 12. If attending college fall 2023, what is the name of school?

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* 13. What are your technology interests?

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* 14. What are your non-technology interests/hobbies?

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* 15. How important is it for you to be matched with a technologist of your same race/ethnicity?

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* 16. If you responded highly or somewhat important, what is your race/ethnicity?

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* 17. Describe why you are interested in having a mentor.

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* 18. Will you commit to a minimum of 4 virtual mentoring sessions, 45-60 minutes each, between June 19 and August 18?

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* 19. Select YOUR TOP 3 GOALS to address during the MentorMash experience

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* 20. Other information you'd like to share

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