Mentoring Program Application

Advising & Retention

Tutoring

EKU has a variety of programs (SEE: Descriptions) that offer mentoring to its' students. The questions below will help us match you with a mentoring program, and will assist us in making the best match possible! The goal of this application process is to ensure that our mentees and mentors have the best experience possible in our programs. We thank you for your interest and look forward to meeting you!

Name
Local Street Address
City
State
Zip Code
Major
E-mail Address
Local Phone
Cell Phone
Expected date of graduation
Department
I would like to be a MENTOR I would like to be a MENTEE
I would like to be matched by: (Please select one): Gender (WILL, Multicultural Student Affairs) Race or Ethnicity (Multicultural Student Affairs, SPICE, International Students) Project Success Athletics Other (EPC, NOVA) Undecided/Other (PLUS Mentoring) Please Match Me! Are you interested in us matching you? If so, we will look at your interests and preferences and match you with a program and mentor or mentee that best suits your needs!
Please check those areas that you would like us to take into consideration when matching you with a program and/or mentor or mentee! My children Major/Minor Interest in athletics Ethnicity Cultural diversity Non-Traditional Student First Generation College Student International Student PELL Eligibility Living & Learning Communities Interests - General Sexual Orientation
My interests and hobbies are:
Ethnicity: White African American Hispanic American Indian/Alaskan Native Asian American/Pacific Islander International (If International, list Country: )
Gender: Male Female
Please take a minute to write a brief paragraph about why you would like to be a mentor or mentee and what you hope to gain in the program. (Please include any additional information that you think will help us in making the best match for you!)

PLUS/Mentoring Purpose Tale of the Mentor FAC/STAFF/ADMIN Mentoring Peer Mentoring Student Mentees What Mentoring Can Be Role of Mentors Mentoring Relationship Making Contact Cultural Awareness Effective Mentoring Strategies When to Refer Code of Conduct Resources

Application

EKU PLUS/Mentoring Handbook
SSB, Room 347
521 Lancaster Ave.
Richmond, KY 40475
Tel: 859-622-6778