Exit this survey SUMMA Registration Form The High School for Leadership and Public Service needs you! Take the first step in becoming a mentor in SUMMA (Syracuse University Mentor/Mentee Alliance). Please complete this form so we have all of your information. Thank you! Question Title * 1. First Name: Question Title * 2. Last Name: Question Title * 3. Male/Female Male Female Question Title * 4. Date of Birth: 1 Date Question Title * 5. SU College Information (or other if not SU): College: Major: Class of: Question Title * 6. Marital Status: Single Married/Partner Question Title * 7. Children: Yes No Question Title * 8. Home Address Address 1 Address 2 City State Zip Question Title * 9. Work Address: Company Address 1 Address 2 City State Zip Question Title * 10. Contact Details: Home Phone Cell Phone Work Phone Preferred Email Address Alternate Email Address Question Title * 11. What is the nature of your current job or career? Question Title * 12. What are your special interests, hobbies or skills outside of work? Question Title * 13. Which type of student do you prefer? One who already does well in school but needs help with college and career choices. One who may be struggling in school and needs a bit more attention and guidance. Either is fine. Question Title * 14. Best time to meet with your student (click all that apply): Weekdays Weeknights Weekends Question Title * 15. Are you required to travel for extended period of times because of work? Yes No Question Title * 16. If you have any comments, concerns or questions, please enter them here: For questions, please contact Megan Hickey at hickey.megan@gmail.com or Michelle Reason, SUMMA Director, at onemcreason@hotmail.com.Thank you again for your interest in becoming a mentor with SUMMA! Submit