Mentee Enrollment Form

Note: Your contact information will not be published outside the chapter.

* indicates a required field.

  • Select a contact reason
  • Check all that apply
  • What special challenge do you face? What experience do you want help with?
  • Scholastic Status

  • Contact Information

  • A public place (library, coffee house, Potomac River waterfront, etc.) or online (Skype, Google Hangout, etc.)
  • Choose a contact method
  • Choose best time to call
  • STC Membership

  • Type of membership
  • I am a member of the following chapters / communities / SIGs:
  • Form Finish

  • How did you learn about the mentoring program?
  • Please Check the Box to Prove You Are a Human; Not a Robot Form Spammer.
  • This field is for validation purposes and should be left unchanged.
Last modified: September 1, 2017
Print Friendly, PDF & Email