Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
I want to be a:
*
Mentor (must have graduated SUNY Ulster BEFORE 2010)
Mentee (must have graduated SUNY Ulster AFTER 2010)
Highest Degree Obtained
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
INDUSTRY OF INTEREST
*
Art
Media
Banking/Finance
Science/Technology
Sales
Healthcare
Higher Education
Strategic Planning
Theater
Finance Management
Law
Education
Other
Can you commit to meeting with your mentor/mentee once a month for a year?
*
Yes
No
If accepted into the Career Connect Alumni Mentorship program do you agree to complete and submit the online intake form once received?
Yes
No
Signature
Continue
Continue
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