Alumni-Mentor Profile Form

Note: This information will only be viewed by the selection committee for the purposes of matching you with the most compatible mentee available.

Personal Information

Name:

Email:

Address:

City:                                      State:                         Zip:

Work Phone:                                      Fax:

____Male     ____Female

Hometown:

High school:

Education

Major:                                                         Year of Graduation:

Residential College (CAS, Wharton, Engineering, Nursing):

Organizations involved in while at Penn:

Other Degrees/Schools Attended and area of study:

Professional Information

Current Employer:

Job Title:

Job Description:

Other Work Experience (or please attach resume):

Additional Information:

Interests and Hobbies:

Fun Fact:

Please describe your interest in having a mentee:

Please check one of the following according to your availability:

I will have time to meet/communicate with my mentee…

___ once a week     ___bi-weekly      ___monthly     ____bi-monthly

____once a semester

What will be your preferred means of communication with your mentee?

____ meet in person     ____email     ____phone

If you do maintain a relationship over the phone or via email due to your location relative to Penn or the student’s hometown following graduation, would you be willing to meet in person if/when the situation allows (ie: if the student travels, for whatever reason, to your hometown or vice versa)?

 ____yes     ____no

Preferences:

Would you prefer your mentee to be:

____male     ____female     ____no preference

____other preferences:

Or do you prefer to be matched with the first available mentee?

Other Comments/Preferences:

* Additionally, it is the responsibility of the student to initiate contact with their mentor. Upon contact, it is encouraged that both mentor and mentee discuss guidelines for future communication including, how often they would like to contact each other and by what means.