Mentee Registration - PHI CHI THETA

CLOSED - Mentee (Collegiate) Registration

Registration Opens – MARCH 8
Registration Closes – MARCH 22
Week 1 – APRIL 1
Week 2 – APRIL 8
Week 3 – APRIL 15
Week 4 – APRIL 22
Week 5 – APRIL 29

First Name*

Last Name*

Email*

Phone*

City*

State*

Zip*

School*

Graduation Date*

Major*

Chapter Name*

My Gender is:*

Additional Majors or Minors

Fields and/or Industries of Interest*

Resume*

Do you want a Mentor if there is not one available in your areas of interest?*

Yes No

Have you participated in past PCT Mentoring Programs?*

First Time Past Participant

Best Days/Times of Availabilty*

Additional Information to Assist Matching

Please list your goals for this program*

Agreement Statement*

I UNDERSTAND THAT BY REGISTERING AS A PARTICIPANT IN THE NATIONAL MENTORING PROGRAM, I AGREE TO HAVE MY INFORMATION SHARED WITH A MENTEE FOR THE PURPOSES OF THE PROGRAM.

Agreement Statement*

I UNDERSTAND THIS IS A FIVE WEEK INTERACTIVE PROGRAM AND PARTICIPATION IS REQUIRED. IF I AM UNABLE TO PARTICIPATE AT ANY TIME, I WILL NOTIFY PROGRAM COORDINATORS IMMEDIATELY. FAILURE TO DO SO WILL RESULT IN FUTURE PARTICIPATION RESTRICTIONS.