E-mentor Student

Thank you for choosing to participate in the CSB E-mentoring program. Participants will be matched based on the following criteria: Personal and career interests, Life experiences, and background. As a student, we’d like you to send a minimum of one email per month to your mentor. At the end of the school year your time in the program will be over. However, if you would like to stay in touch with your mentor, that is up to you. We will no longer monitor your communications or send you reminders. Ideally, we’d like you to commit for a school year term, but we understand that things come up and you may need to leave the program. If you can agree to these terms, please check the box labeled, “I agree” and complete the remainder of the form. Thank you for your participation in the CSB e-mentoring program!

Agree

Name

Class Year

Email Address

Phone Number

What type of medium would you prefer to use to communicate with your mentor?

	Phone
	Texting
	E-mail
	Instant messaging
	Facebook
	Twitter
	Other

In college I am involved in:

	Student clubs or organizations		Research
	Athletics		CSB Senate
	Music/Theater		Residential Life (RA)
	Volunteering		Other

Major and/or minors in college or if undecided, things are you interested in studying

Personal interests/hobbies or passions (what do you like to do in your free time?)

I plan to do the following in my life (check all that apply)

	Live/Volunteer Abroad after College
	Attend Graduate School
	Participate in a Volunteer Work experience post-graduation
	Study Abroad during College
	College Internship

One challenge and/or one thing I am looking forward to during my sophomore year (i.e. study abroad application, deciding on a major, starting to take classes in my major, etc.)

The thing I have enjoyed most about college is

What do you hope to gain out of this relationship with a CSB alumna?

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