Adult Mentoring Program for Students (AMPS)

Mentor Application Form

If you would like to apply for a Mentor 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 mentee 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 be a mentor:

4. What qualities do you possess that will enable you to be an effective mentor?

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

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

 
                                                                                       

Copyright © 2004 [OASES]. All rights reserved.

Revised: 06/22/07