Send to: Secretary of the Academic Staff, Room 270 Bascom Hall
Due Date: February 8, 2008

Yes! I want to be a Mentee or Mentor (circle one)

Name:

Unit/Department:

Work Address:

Work Phone:

Email address:

How long in your current unit?

How long at the university?

Briefly describe what you do in your current job:

What benefits are you seeking as a mentee?

Or, What skills or expertise can you offer as a mentor?