*1.Personal Information(Required.)

First Name 

Middle Initial

Last Name 

Year of Graduation

Contact Email Address for the Mentor Program

Contact Phone Number for the Mentor Program

*2.What state do you reside in?(Required.)

Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia (DC) Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin WyomingCity or Town?

*3.Are you volunteering to be a Mentee or Mentor(Required.)

Mentee

Mentor

*4.Can you commit to at least one Zoom or phone meeting per month with your Mentee/Mentor?(Required.)

Yes

No

*5.What Industry or Field of Expertise do you work in or intend to purse?(Required.)

*6.What was/is your academic area of study at Holy Cross?(Required.)

7.What are your personal interests or hobbies outside of work or school

Interests:

Hobbies:

*8.Do you agree to a code of conduct that is mutually respectfully of  time, privacy and behavior? (Required.)

Yes

No