Peer+Connect Mentorship Registration Form
Name
First Name
Last Name
E-mail
example@example.com
Campus
Atlanta
Chattanooga
Online
Are you a new student?
Yes
No
Degree Program
Additional Certificate or Thesis
Location (City/State)
Mentoring Interest (e.g. phase of life, connection, support)
Mentoring Preference (e.g. BIPOC, geographic location, campus, age range)
If there is a student you'd like to be paired with, then please list their name. Please be sure to speak with whomever you list below.
As a participant in this program, I understand:
The expectation is that this mentorship will last one semester.
Application deadlines for Peer+Connect are the following:
Fall Semester | Due September 1
Spring Semester | Due January 1
I understand and agree to all the above mentioned items that are a part of the Peer+Connect Student Mentorship Program at Richmont Graduate University.
*
Yes, I do.
Submit
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