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First Name
Last Name
Email Address
EMPLID
Phone number
Academic Program
BA Communication and Media
BA Disability Studies
BA Human Relations
BA Liberal Studies
BA Psychology
BA Sociology
BA Youth Studies
BPS Applied Management and Entrepreneurship
BS Business
BS Health Information Management
BS Health Services Administration
BS Information Systems
BS Nursing
Other
Academic Program: You selected other, please tell us your academic program.
How do you define your race? (Select all that apply)
Black or African American
Native Hawaiian or Pacific Islander
American Indian or Alaskan Native
White/Caucasian
Asian
Hispanic/Latino
Other
How do you define your race?
How do you define your gender Identity?
Man
Woman
Transgender
Gender nonconforming
Non-binary
Prefer not to disclose
Other
Tell us your pronouns:
Please indicate how much time you took off from school before enrolling at CUNY SPS:
I enrolled immediately after my previous school
Less than 1 year
1-2 years
3-4 years
5+ years
Have you enrolled in classes?
Yes
No
Have you taken fully online courses before?
Yes
No
Why did you decide to enroll at CUNY SPS?
Tell your peer-mentor about yourself!
For example: social identities; friends and family; hobbies; volunteer work; favorite music, movies, books, and TV shows; any other information to help a mentor get to know who you are.
What areas do you hope to receive mentorship in?
Time Management
Study Skills
Academic Guidance
Stress Management and Wellness
Leadership Skills
Sense of Belonging
Clubs & Organizations, Campus Involvement
Other
What areas do you hope to receive mentorship in?
What communication methods do you prefer for connecting with your mentor?
Text message
Phone call
Video call
WhatsApp
Email
What role do you hope your peer-mentor will play as you adjust to CUNY SPS?
Optional - Please share any other information you would like a mentor to know about you if selected for the program.
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