Stockton's CARE Program Participation Survey

Program Mentor Application Form

Thank you for your interest to serve our students as a volunteer Scholars Program Mentor. Please complete the form below and click the submit button at the bottom. The answers you provide will be used to create more compatible match possible.

Please note that the information you provide on this questionnaire will be used to update your mentor profile on Mentors & Tutors web page. If you would like to submit a picture of yourself to use as well, please email Tom Itaas directly at Tomas.Itaas@stockton.edu.

Again, thank you for your anticipated support to Stockton students and the Success Scholars Program.

Program Mentor Application Form

Thank you for your interest to serve our students as a volunteer Scholars Program Mentor. Please complete the form below and click the submit button at the bottom. The answers you provide will be used to create more compatible match possible.

Please note that the information you provide on this questionnaire will be used to update your mentor profile on Mentors & Tutors web page. If you would like to submit a picture of yourself to use as well, please email Tom Itaas directly at Tomas.Itaas@stockton.edu.

Again, thank you for your anticipated support to Stockton students and the Student Success Scholars Program.

First Name

Last Name

Preferred Email Address

Phone Number

Hometown

College(s) Attended

Degree/Major You Studied

What is your preferred method of communication? (i.e., email, phone, social media, etc.) Please provide address, number, or handle where you may be reached.

What are some of your favorite hobbies?

Your favorite book and movie:

Are you bi-lingual?

No
If yes, which language?