ALABAMA A&M UNIVERSITY
CHANGING LANES MENTORING PROGRAM
MENTEE APPLICATION

The following questions will assist us in assigning you to a mentee. Please complete the form below and click the submit bottom upon completion. For further information please feel free to contact The Office of Retention and Academic Support at (256) 372-5493 or email us at ChangingLanes@aamu.edu

Last Name First Name
AAMU ID
Dorm Phone Number (Area code first) Cell Phone
Email Facebook Name
Contact Address
City State ZIP code
Gender: Male Female
Classification: Freshman Sophomore Junior Senior Graduate Student
Intended Major
Which best describes your personality? Introvert Extrovert Average
Which group will be ideal for your mentor: (click on a box)
Peer/Student Staff Faculty Community Professional
Indicate your religious preference for you mentor
What do you like to do in your free time?
What are your hobbies?
What extracurricular activities would you like to be involved with?
What are your expectations of your mentor?
What are your career aspirations
Please provide us with any information that may assist us with selecting a mentor for you.
The information provided will be treated with the strictest confidence and will only be shared with this office and your mentor. Can we provide your mentor with your contact information? Yes No

If you have any questions about the program, or your mentoring relationship please feel free to contact the Office of Retention and Academic Support at:
Phone: (256) 372-5493
Fax: (256) 372-5495
Email:howard.wright@aamu.edu