Name *

First Name

Last Name

Which mentorship-related wishes do you have? *

I want to participate in a short (4-week) program

I want to find a mentee 1-on-1 without joining a program

I have to have a coffee chat with a mentee (1-time meeting)

If you're comfortable, please select any ethnic/cultural groups that you identify with.

This data helps us better understand who exactly we're serving and the various backgrounds our GEM Program participants have. We will not share this data with your mentee(s).

American Indian or Alaska Native (e.g., Navajo Nation, Blackfeet Tribe, Inupiat Traditional Gov't., etc.)

Asian or Asian American (e.g., Chinese, Japanese, Filipino, Korean, South Asian, Vietnamese, etc.)

Black or African American (e.g., Jamaican, Nigerian, Haitian, Ethiopian, etc.)

East Asian: Chinese, Japanese, Korean, Okinawan, Taiwanese, Tibetan.

Hispanic or Latino/a (e.g., Puerto Rican, Mexican, Cuban, Salvadoran, Colombian, etc.)

Middle Eastern or North African (e.g., Lebanese, Iranian, Egyptian, Moroccan, Israeli, Palestinian, etc.)

Native Hawaiians and Pacific Islanders: (in the U.S. Jurisdictions & Territories) Carolinian, Chamorro, Chuukese, Fijian, Guamanian, Hawaiian, Kosraean, Marshallesse, Native Hawaiian, Niuean, Palauan, Pohnpeian, Papua New Guinean, Samoan, Tokelauan, Tongan, Yapese.

South Asian: Bangladeshi, Bhutanese, Indian, Maldivians, Nepali, Pakistani, Sri Lankan.

Southeast Asian: Bruneian, Burmese, Cambodian, Filipino, Hmong, Indonesian, Laotian, Malaysian, Mien, Singaporean, Timorese, Thai, Vietnamese

White or European (e.g., German, Irish, English, Italian, Polish, French, etc.)

If you're comfortable, please select any gender-related groups that you identify with.

This data helps us better understand who exactly we're serving and the various backgrounds our GEM Program participants have. We will not share this data with your mentee(s).

Transgender

Woman

Man

Gender Non-binary: Gender nonconforming, Genderqueer, Nonbinary

Were you or are you a first-generation college student? *

Yes

No