Multicultural Student Life | The University of Tennessee, Knoxville

Minority Achievement Program Mentee Application

Last Name

First Name

Middle Initial

Gender

Race/Ethnicity

Class

Prospective Major

UT Net ID (if available)

UT Student ID (if available)

Home Street Address	City
State	ZIP Code

Home Phone Number

Cell Phone Number

Summer Email Address

What is the best way for a mentor to contact you at the start of the fall semester?

Face to face

Summer Email Address

UTK Email Address

Cell Phone

Skype

Other

Graduating High School Name

High School GPA

How do you think you will benefit from the Multicultural Mentoring Program?

What are three (3) words that best describe you?

What type of activities did you participate in during your high school career?

List any academic or extracurricular activities that you hope to pursue in college.

What are your interests and hobbies?

Do you intend to seek employment during the academic year, either on campus or off campus?

Yes

What other aspects about yourself would be helpful to know to match you with a mentor?

Check the areas where you feel MMP or your mentor may be able to support you.

Being away from family and friends at home	Handling social pressures of college	Adjusting high school study habits to those needed in college
Performing well academically	Balancing academic and social life	Other

Other

Multicultural Student Symposium

The Multicultural Mentoring Program (MMP) and the Office of Multicultural Student Life will host a one-day symposium on August 20, 2013, from 9:00 am – 3:00 pm. The symposium will consist of informational sessions, mentor/mentee bonding activities, faculty/staff/student panels and so much more! The symposium is open to the first 125 students to register, and there is NO COST to participate in the symposium.

The deadline for registration is August 2, 2013.

I would like to attend the Multicultural Student Symposium

Yes

I am a participant in the UT LEAD Summer Institute

Yes

I am a participant in the Housing Learning Communities

Yes

Release Statement

I understand that the submission of an application evidences my consent for and authorization to the Multicultural Mentoring Program to access and review any and all educational records in my name or relating to my enrollment at the University of Tennessee. I verify that the information I have provided on the application is true and accurate.

Solve this math problem:

Disclaimers

The University of Tennessee does not discriminate on the basis of race, sex, color, religion, national origin, age, handicap or veteran status in provision of educational opportunities or benefits.

The University of Tennessee does not discriminate on the basis of sex or handicap in the educational programs and activities which it operates, pursuant to the requirements of Title IX of the Educational Amendments of 1972. Public Law 92-318; and Section 504 of the Rehabilitation Act of 1973, Public Law 93-112, and the Americans with Disabilities Act of 1990, Public Law 101-336, respectively.

This policy extends to both employment by and admission to the University. Inquiries concerning the Title IX and Section 504 and the Americans With Disabilities Act of 1990 should be directed to the Office of Affirmative Action, 2110 Terrace Avenue, The University of Tennessee, Knoxville, Tennessee 37996-3558 or call (865) 974-2498. Charges of violations of the above policy should also be directed to the Office of Affirmative Action.

The University of Tennessee, Knoxville. Big Orange. Big Ideas.

Knoxville, Tennessee 37996 | 865-974-1000
The flagship campus of the University of Tennessee System