Adult Mentoring Program for Students (AMPS)

Mentee Application Form

If you would like to apply for a Mentee position with the Office of Adult Students and Evening Services, please complete and submit this form. The          information submitted will be reviewed by an Academic Counselor in the OASES office, and you will be contacted regarding your submission.

Name:  

Academic Major:  

Local Address:  

Telephone Number:  

City:  

State: Zip:

UNCC Email Address:  

1.  Please click your mentor preference.        Male         Female   

2.  How did you hear about AMPS? 

Please click:  email,  flyer,  friend,  orientation,  website     *if other list below.

 3. Describe your reasons for wanting to have a mentor:

4. What do you hope to gain from the Adult Mentoring Program for Students?

5. What influences your life (i.e. family, fitness, job, other organizations)?

 

                 


Copyright © 2004 [OASES]. All rights reserved.
Revised: 06/22/07