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* 1. First Name

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* 2. Last Name

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* 3. Designation (Pre-health area of study)

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* 4. R# (Please use the format: R12345678)

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* 5. TTU E-mail Address

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* 6. Preferred Point of Contact (this information will be shared with your mentor when matches are made at the start of the fall semester. Can be an email or a phone number)

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* 7. Overall GPA

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* 8. Science GPA (Please provide the average of the sciences required by admissions to your professional program of choice. You may leave this field blank if you have not yet completed any sciences.)

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* 9. Personal Statement (Please describe how you would benefit from participation in this program.)

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* 10. Campus, Community & Professional Involvement (Please provide a brief description of any clubs, organizations, volunteer/shadowing, work experience you have. Include dates, hours, and a brief description of activities.)

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* 11. In terms of community involvement, what drew you to that/those particular volunteering role(s)? Why is community involvement and outreach important to you?

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* 12. The mentor Program is for students who are not yet on their application semester for their designated health program. Please certify below that you have not applied, or are not currently applying this semester (Spring/Summer 2023) for your health program.

This next section will be used for matching purposes only. Responses to questions in this section will have no bearing on selection. You may choose to skip this section if you do not wish to respond to any of the questions.

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* 13. Have you been a part of any other mentorship programs or opportunities in the past? Either in your first year of college or in high school? Please list which ones. (Examples include Mentor Tech, First Gen, TRIO, etc.,)

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* 14. How important is it to you that your mentor have a similar experience with mentorship or organizations that you have had? (You would like a mentor that has also been a part of Mentor Tech, First Gen, TRIO, etc.,)

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* 15. Did you attend a high school that had less than 200 students in your graduating class?

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* 16. How important is it to you that your mentor also come from a high school with fewer than 250 students in their graduating class?

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