Diverse Scientist Mentorship Program Application – Yahng Discovery Center

Mentee Application

Full Name (First and Last) *

Current Academic Standing (Years at Berea College) *

Hometown (County or City, State)

What is the best way for your mentor to keep in contact with you? *

Phone/ Cell phone
Email
Other: Answer in box below

Other

Email *

(The one that you check frequently)

Phone Number *

Area of Study/ Interest *

Race/ Ethnicity

Gender Identity

How did you hear about this program? *

YDC Website
School (Professor, Student, Peer)
Word of mouth
Other: Answer in box at below

Other

Why do you want to join this program? *

What are some challenges that you think you will face while pursuing a higher education at Berea College? How would the mentoring program help you overcome these obstacles? *

What do you hope to gain from your mentee experience? List 3 things that you would like your mentor to provide. *

Please list any hobbies, interests, or comments that you would like to add that would help us make a good match.

Please provide the classes you are taking or will be taking when the mentorship program begins.