Promise Mentor Verification

DRAFT

Nevada Promise Mentors, please use this form to:

  • Update your personal and professional information.
  • Indicate preferences of Campus and meeting times.
  • Increase or decrease the number of students you are committed to mentoring.
  • Withdraw from the program or defer participation until the next Academic Year. 

 

MENTOR INFORMATION
MENTOR STATUS
Please indicate if you wish to continue participating in the Nevada Promise Mentoring Program?
CONTINUE MENTORING

You can withdraw from the program or defer your participation until the following Acacemic Year. 

Withdraw from program?
Are you a CSN Employee?
CSN EMPLOYEE INFORMATION

CSN Employees please enter CSN School, and campus where you spend the most time. 

As a CSN Employee, which campus do you spend the most time at?
PREFERENCES

For FUTURE pairings, we will match mentors and students based on preferences as much as possible, however, we ask that Mentors maintain flexibility as this may not always be possible. 

Preferred days to meet:
Preferred Times of day to meet:

For NEW pairings, mentors can be paired with up to 10 students in one Academic Year. CSN recommends that each Mentor commit to a manageable number of students.

Do you need to update your email or phone numbers?
UPDATE EMAIL & TELEPHONE
Do you need to update your Company information?
UPDATE COMPANY INFO
Please choose your company from the drop-down selection. If you don't see your company, choose "Other" to enter it manually.
If your company is not listed, please enter it below:
Do you need to update your Address?
UPDATE ADDRESS
Do you need to update your Credentials?
UPDATE CREDENTIALS
Please list each certification on a separate line: