Mentor Pairing Application

First Name *

Last Name *

Student ID Number *

CSUN Email Address *

Phone Number *

Please enter the best phone number to reach you.

Academic Major *

If you have yet to declare a major, please put an area of interest

How do you choose to identify?

Please list any identifiers you find important for your Mentor to know (i.e. race/ethnicity, cultural background, religion, sexual orientation, gender identity, etc.) Feel free to list as many as you wish, or none at all.

What are some of your hobbies and/or interests? *

What are your career goals/interests? *

What are you interested in being involved with on campus? *

What do you expect to gain from the mentoring experience? *

What type of relationship do you envision having with your mentor? *

If you answered yes, please expand on how you would like to identify with your Mentor. *

Anything else you would like the Program Coordinator to know?

Comments, concerns, etc.

Division of Student Affairs

Student Development & Transitional Programs

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Mentor Pairing Application

Please submit the following application to receive a mentor within our program. We encourage you to be as thorough as possible in your answers - the more we know about you, the better we can pair you with a mentor that properly suits your needs and expectations.

Please note: This application may take upwards of 20 minutes to complete.