Mentoring Application for Alumni

First

Last

Email

Preferred Phone

Preferred Phone
Preferred Phone Type Phone Ext:

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Did you earn an undergraduate degree at UK?

Campus Location

Are you a returning mentor or new to the program?

What was your undergraduate engineering major?

Would you like to remain with your current student(s)?

Student names (s)

Student names (s)
	Student names (s) First Last	Item weight

more items

What year did you receive your undergraduate degree?: Year

I am a returning mentor and the following information has not changed since the previous application.

Geographic Regions in which you've resided

Have you earned one or more graduate degrees?

What is the Graduate Degree and Graduation Year?

Activities as an Undergraduate

Which Engineering Organizations did you participate in?

Current Employer

Current Position Title

Area of Expertise/Industry Sectors

Which area would you prefer your match to be based on?

Would you be willing to mentor more than one (1) student?

How many?

I verify that I have read the Mentor Program handbook and agree to the expectations outlined.

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Mentoring Application for Alumni

Stanley and Karen Pigman College of Engineering