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ALUMNI MENTORING PROGRAM

MENTOR APPLICATION

* Required Fields
* Name (First and Last):
* Home Address:
* City:
* State:
* Zip Code:
* Home Phone:
Cell Phone:
* E-Mail:
* Are you a member of the Cal State L.A. Alumni Association? Yes  No
   
Employer:
Employer Address:
City:
State:
Zip Code:
Type of Business:
 
 
* Required Fields

Educational Information

* Year(s) Graduated from
Cal State L.A.:
Degree/Certificate Earned: Yes  No
If so, name of degree:
Any additional degrees received?:
Name of Institution/Degree/Year Received:
* Academic Majors/Concentrations:
 
 

Mentor Information

How do you prefer to communicate with your mentee?: Email, Phone, Personal Visits
(check all that apply)
   
In what geographical area are you willing to meet a mentee?