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Contact information

Name:

Student ID:

Phone:

Home
Cell
Business

Email address:

Personal
Business

Academic information

Class standing:

Academic college:

Major:

Student groups:

Special interests:

Availability

How soon would you like to arrange your meeting?
3-4 weeks
next month
as soon as possible
no preference

Which days of the week are generally best for you?
Monday
Tuesday
Wednesday
Thursday
Friday

During which hours are you available to meet?
weekday mornings
weekday afternoons
weekday evenings
weekend mornings
weekend afternoons
weekend evenings

Where would you prefer to meet?

Professional goals

Please briefly describe your prefessional goals and interests.

Expectations

What do you hope to gain from this experience?

How did you hear about SavorUB?

Were you referred to the program? If yes, by whom were you referred?

Leave this field empty

 

Last Published 3/8/16