Please fill out the following form to request a mentor. Please be sure to know the requirements before applying.

You must be a junior, senior or graduate student.

PERSONAL INFORMATION

First Name   Last Name

Address

Address 1
        
Address 2

City  

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Telephone


Email address  

MAJOR/MINOR:

HOW ARE YOU ASSOCIATED WITH EEE? (MAJOR/MINOR/GRAD STUDENT/CIE/E-CLUB)

GPA:

YEAR OF GRADUATION:

DEGREE:

COURSE LOAD:

HOURS YOU ARE WILLING TO DEDICATE TO YOUR MENTORSHIP PER MONTH

1. PARTICULAR INTERESTS RELATED TO ENTREPRENEURSHIP

RLEVANT CLASS EXPERIENCE:

2. PLEASE DESCRIBE THE REASONS YOU ARE SEEKING A MENTOR RELATIONSHIP.

3. WHAT ARE YOUR GOALS FOR THE MENTOR RELATIONSHIP, AND HOW ARE YOU PLANNING TO ACHIVE THEM?

4. DO YOU HAVE ANY PREFERENCES IN TERMS OF THE TYPE OF ENTREPRENEURIAL MENTOR YOU ARE ASSIGNED (E.G., AGE, GENDER, INDUSTRY)?

5. WHAT ARE SOME OF THE PERSONAL INSIGHTS ABOUT THE ENTREPRENEUR YOU WANT HIM/HER TO OPEN UP ABOUT?

6. WHAT ARE SOME OF THE PERSONAL INSIGHTS ABOUT YOURSELF YOU ARE WILLING TO SHARE WITH THE MENTOR?