Skip Navigation


Student Services

Section Navigation:

Student Mentor Questionnaire

SPEA IUPUI Mentorship Program - Student Questionnaire

*An asterisk indicates a required field.

*Name:
 
*Student ID
 
Address:
 
*E-mail:
 
*Phone:
 
SPEA Degree Sought:
 
Expected Graduation Date:
 
Why do you want a mentor (e.g., sharing experience, advice, introductions, friend, etc.)?
Characters remaining:
Describe your ideal mentor (e.g., field of work, industry, interests, etc.)?
Characters remaining:
Please list past employers and occupations (if any):
Characters remaining:
Please list community service and volunteer activities (if any):
Characters remaining:
Other Degree(s) - please list educational institution, degree, and year of graduation (if any):
Characters remaining:
Desired career goal (if known):
Characters remaining:

What are Your Interests?  Check the items (as many as apply) in which you are interested.
Advocacy and Human Rights Immigrants and Refugees
Animals International Issues
Children and Youth Justice and Legal
Community Building Media and Broadcasting
Computers and Technology Music
People with Disabilities Politics
Education and Literacy Public Safety
Employment Race and Ethnicity
Environment Religion
Fine Arts Seniors
Gay Lesbian Bi and Trans Sports and Recreation
Health and Medicine Women's Issues
Homeless and Housing Other
Hunger    
Other:
What are Your Skills/Talents?  Check the items (as many as apply) that you would consider a skill in which you are proficient.
Advocacy Politics
Budgeting Program Design
Business Development Public Affairs
Career Planning Public Finance
Communication Public Relations
Community Organizing Public Speaking
Counseling Research
Data Management Special Events
English as a Second Language Succession Planning
Facilitation Teaching/Meeting Facilitation
Fundraising Team Building
Information Technology Training
Investing Volunteer Recruitment
Journalism Website Development
Leadership Writing
Marketing Other
Policy Development    
Other:
Please check which of the following you would be willing to participate during the course of a mentor relationship (this does not commit you to all activities, but allows us to match with a mentor with the same mentoring objectives).
Regular, informal meetings with student (required)
Mentoring events (required, when logistically possible)
Exposure to events, individuals or organizations in my professional field or expressed interests
Introductions/networking with colleagues
Job shadowing
Career planning advice/assistance
Referrals to resources related to class projects
Please confirm the following:
I am available and will meet in class on September 18, October 16, and November 13 from 9:00 a.m. - 1:00 p.m.
I will also attend a required professional development activity on campus (such as the Etiquette Luncheon).
I will meet with my mentor at least three times this semester outside of class.