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THE MAN CENTER MENTORING APPLICATION FORM
Please fill in each blank and submit to us. You will receive a confirmation that your application has been
received. The information provided below will be used for the task of matching peer mentor/mentee
relationship.
Mentee Application
First Name:
Last Name:
Mailing Address: City:
Home/Cell phone:
Student ID #:
State:
ZIP:
E-mail address:
Cumulative GPA:
Current classification: Graduate Undergraduate
Birth date:
Married:
Children:
Degree Major/Minor:
How or from whom did you learn about The Man Center?
What languages do you speak?
Interests/Hobbies
Financial aid
Date of last submitted FAFSA (This information is solely used to help insure you have what you need)
To match prospective mentors with your available schedule, please be specific as possible and list all your
available days and times this semester
Monday:
Times
Tuesday:
Times:
Wednesday:
Times:
Thursday:
Times:
Friday:
Times:
Who has been the most influential person/mentor in your life and why?
What do you hope to gain personally and professionally from being a mentee?
Why do you think you will be a good mentor?
Have you been a mentor/mentee before? If so, what did you learn about yourself from that relationship?
Please provide a two to three sentence bio for our website
Please send a photo of yourself (head and shoulders) to rarnold2@tnstate.edu .
Send a copy to my email for my records (Mr. Arnold). By submitting this application, you confirm that all
information provided is accurate to the best of your knowledge and you will represent the Man Center
Mentoring Program with the highest respect.