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Student Alumni Mentorship (SAM) Program Application Form
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Student Alumni Mentorship (SAM) Program Application Form
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I would like to apply to be a...
Alumni Mentor
The deadline for alumni mentor applications for the Winter 2026 program is November 4, 2025 at noon (Pacific Time).
Student Mentee
Only Student Alumni Association (SAA) members are eligible to apply for this program. Student mentee applications for the Winter 2026 program close November 4, 2025 at noon (Pacific Time). Late application submissions will not be accepted.
First Name
Last Name
Pronouns
Email
Phone Number
Current City/State/Province/Country
Hometown
Indicate if different from current city/state/province/country
Time zone in which you live during participating quarter (Winter 2025 quarter)
LinkedIn URL (if applicable)
School Year
First Year
Second Year
Third Year
Fourth Year
Fifth Year or beyond
Expected Graduation Date (month and year)
Major/Minor
Career Interests
Personal Interests
Career Field/Major
Employer/Company Name
Job Title/Position
Years of Experience (in current field)
Have you ever had a career change and would you be willing to share insights about your previous career and/or career transition with your mentee?
No
Yes
Enter other…
Please specify previous career
We aim to create meaningful mentor-mentee pairings by considering shared experiences and identities beyond career interests. If you're comfortable, please indicate any identities you hold that you feel are important to share for the matching process (select all that apply):
Woman
Man
Non-binary, genderqueer, or gender nonconforming
Transgender
LGBTQ+ community
Black, Indigenous, or Person of Color (BIPOC)
International Student
First-Generation College Student
Transfer or Re-entry Student
Veteran or Military Affiliated
Student Parent or Caregiver
Student Athlete
Person with a disability
Prefer not to disclose
Other salient identity (please specify)
Enter other…
Preferred Form of Mentor-Mentee Communication (Select all that apply)
Email
Phone - Call
Phone - Text
Preferred Mode of Mentor-Mentee Meetings (Select all that apply)
Phone Call
Video Call
In-person Meetings
What is the best time for you to meet with your mentor/mentee?
Please add times and days. Ex: I am free Wednesdays after 2 PM or I am available Monday, Tuesday, and Friday in the morning.
Are you participating in other activities (aside from classes) that could potentially conflict with your ability to participate in this program? If applicable, please list potential conflicts.
Which of the following do you feel you can offer a potential mentee or would like to get help with from a mentor? (Select all that apply)
Assistance with career exploration
E.g., discuss career alternatives or explore what you can do with given major
Assistance with career planning
E.g., discuss post-graduation plans and next steps
Assistance with job search
E.g., review resume, conduct practice interview
Assistance with life skills
E.g., discuss time management skills, work-life balance strategies, general office etiquette
Networking opportunities
Why would you like to be a mentor/mentee?
Are you willing to mentor more than one student?
Yes
No
How did you hear about the program? If referred, please include the name of your referral.
Data sharing consent
I consent to sharing all information provided on this form, including personal data, with (1) the Student Alumni Mentorship Program Coordinators and a volunteer sub-committee for the purpose of facilitating the matching process, and (2) my assigned alumni mentor/student mentee to support effective mentor-mentee communication.