AIRC-Full Circle Mentor Request Form

Please enter your full name:

Enter your e-mail address:

Enter your tribal affiliation/s:

Select Class Standing: -- Select Class Standing -- Freshman Sophomore Junior Senior Graduate Student

Gender: Female Male

Do you live on campus? Yes No

Select College: -- Select College -- Cowell College Adlai E. Stevenson College Crown College Merrill College Benjamin F. Porter College Kresge College Oakes College College Eight College Nine College Ten Grad Student

1) Please explain in two paragraphs why you are intrested in being mentored?