UNG Connect

UNG GEN 1 Mentor Application

A mentor is an experienced and thoughtful person committed to investing time to assist in the growth and development of others. The mentor is willing to share their knowledge, experience, and wisdom and act as a guide and role model.

A mentor supports and encourages the mentee's development and provides active guidance to help them achieve their goals. The mentor offers a fresh perspective and an independent point of view while guiding a process that fosters the growth and educational development of the mentee.

If you need assistance completing this document or require it in a different format, please contact Student Disability Services at diability-gvl@ung.edu or 678-717-3855.

What gender do you most closely identify with? *

Male

Female

Genderqueer/ Non Binary

Other: Please specify below

Prefer Not to Disclose

Comments:

What is your race/ethnicity? *

Asian/ Pacific Islander

American Indian/ Alaskan Native

Black, non-Hispanic

Hispanic/ LatinX

White, non-Hispanic

Prefer Not to Disclose

Do you have experience mentoring students or young adults? *

Yes - Specify Below

Comments:

What is the best way for your mentee to communicate with you? * (Maximum authorized answers: 3)

In Person

Video Call ( Skype, Microsoft Teams, Zoom, facetime, etc...)

Phone Call

Other: Please specify below

Comments:

If given a preference, I prefer my mentee to be: * (Maximum authorized answers: 3)

Male

Female

Genderqueer/ Non Binary

Other: Please specify below

No Preference

Comments:

If given a preference, I prefer to mentor a student who: * (Maximum authorized answers: 2)

Has potential for degree completion, but requires more support

Has potential for degree completion with low to moderate support

Member of racially or ethnically underrepresented population

No Preference

Are you willing to communicate regularly and openly with program administrators, provide monthly information regarding your mentoring activities and feedback regarding your participation in the mentoring program? *

Yes

No - Specify Below

Comments:

Are you willing to attend an initial mentor training session and refresher sessions each year you participate in the program? *

Yes

No - Specify Below

Comments:

By signing and submitting this form, I attest to the truthfulness of all information provided and certify my willingness to participate in the UNG GEN 1 Mentoring Program. *