Mentor Profile

Personal Information

Title:

First Name:
Last Name:

Gender:

Employment Information

Company:
    
Title:

Industry:

Please specify your industry:

 

Preferred Contact Information

Preferred Contact:

Street Address:

City:
    
State:
    
Zip:


Phone:
   
Fax:

E-mail:


Professional Information

How many years of work experience do you have, since attaining your undergraduate degree?

Area of Expertise:

Undergraduate University:
    
Undergraduate Degree:

Graduate School History:

Area(s) where you might serve as a mentor. Please rank in order of preference.

Please provide a 100+ word bio. It is important for us to match students and mentors based interests and experiences:


Northern Michigan University Reference

Name:
    
Title:

E-mail:

Phone:

Would you be interested in any of the following? Please check all that apply