Mentee Questionnaire (please print
clearly)
Name___________________________________________________________________
Address_________________________________________________________________
City__________________________________________State________Zip___________
Phone # ______________________________Alternate #__________________________
Student ID #__________________________________
E-mail _______________________________________
(If you do not yet
have an e-mail account, please provide one to the Mentoring Program Office
after you activate your IPFW account.)
What are some of your favorite activities/hobbies? ________________________________________________________________________
What type of assistance would you like to have from your mentor?
________________________________________________________________________
What type of mentor do you prefer? (Circle all that apply)
Student Faculty/Staff Male
Female
Are you familiar with
What is your major? How many credits
are you enrolled?
Do you work? Yes _____ No____ if yes, how many hours?
What days or times are you available to meet with your mentor?
________________________________________________________________________
What other information do you feel might help us to better match you with a mentor?
________________________________________________________________________
Signature______________________________________________Date______________
Please mail your completed forms to:
IPFW Dean of Students
Freshman Mentoring Program