TCCP Women in Tech Mentoring Program Mentee Application
Your Full Name
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First Name
Last Name
Where do you currently live?
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Your Email Address
*
Your Phone Number
*
What type of communication do you prefer?
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Remote
In-Person
Hybrid of remote and in-person
If you are interested in in-person meetings with your Mentor or Mentor Group, do you have access to reliable transportation?
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YES, I have access to reliable transportation.
NO, I'll need help with transportation.
Current College/University
*
Please Select
Central Penn College
Gettysburg College
HACC
Harrisburg University of Science & Technology
Penn State University
Thaddeus Stevens College of Technology
York College
What is your anticipated graduation year? (The WIT Mentoring Program is most appropriate for junior and senior level students.)
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What is your current (or anticipated) major(s)?
*
What career, role or type of work do you hope to secure after school?
*
Why are you interested in being part of the WIT Mentoring program?
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Have you participated in any mentoring program before?
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Yes
No
Please tell us about your prior experience with a mentoring program. What went well and what did not meet your expectations?
*
If selected for the WIT Mentoring program, you will be matched with both a Mentor and a Mentoring Group. You will be expected to connect with your Mentor at least one time per month and attend monthly virtual group meetings. Do you agree to these expectations?
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Yes
No
Is there anything else that you think would be helpful for us to know about you? You are welcome to provide as much information about yourself and your goals as you are comfortable. This information will be used to help to match you with a Mentor.
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