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Application Form For Student

Your Last Name *

Your First Name *

Email Address *

Cell Phone *

What is your gender? *

Male
Female
Prefer not to say
Other

other

What's the name of your university? *

What's your course of study *

What's the duration of your course of study? *

Less than 2 years
2 years
3 years
4 years
5 years
More than 5 years

In what year (or level) are you currently? *

1st-level
2nd-level
3rd-level
4th-level
5th-level

List all the languages you speak and your level of proficiency in each.

Why do you seek university or college education? What is your goal? *

Apart from your university or college education, what are you doing really well that is helping prepare yourself to achieve this goal? *

What challenges or skill gaps do you see on your path to achieving this goal? *

Describe a meaningful achievement you have made in the past that you are most proud of. Why are you so proud of the achievement? *

Why do you want to participate in the VarsityMentor program? *

Write an introduction of yourself for your future mentor. Include anything that you would like them to know about you, your strengths/weaknesses, and your hopes (e.g. who you are, your education journey so far, why you are becoming a mentee, your expectations of this program, what you hope to put into place to ensure you realize the maximum benefit from this program, etc.). *

Please provide your LinkedIn Profile page

Please provide your Facebook Profile page

Name three people in the world that inspire you (at least, one of them should be an African). Why do they inspire you? *

Name of first reference *

Email address *

Phone

What's your relationship with this reference? *

Name of second reference *

Email address *

Phone

What's your relationship with this reference? *

I understand that I will be matched with a mentor based on my responses to this application form and based on available mentors *

Yes

Is there any other thing you would like to share with us?

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Contact Info

Address: PO Box 23637
San Jose
CA 95153
Email: info@varsitymentor.org
Phone: +1 669 444 2367

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