SIU Women's Leadership Council - Mentor Application
Please complete the form below to apply for our mentorship program. Please note you will need to attach a copy of your bio in resume format (sample provided below).
Full Name
First Name
Middle Name
Last Name
Current Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email Address
example@example.com
Phone Number
LinkedIn
Race/Ethnicity
Current Employer & Position
What is your relationship to SIU? (Alumni (Degree & Year), Parent, Employee)
Were you a first-generation college student?
Yes
No
Do you have a preference on a student's field of study?
Why do you want to participate in this mentorship program?
Please give an example of a person that you have mentored in the past and how your mentorship has made an impact in their life.
SAMPLE BIO
Upload Your Bio
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Submission Date
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Month
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Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
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