AccessComputing Mentors Application

AccessComputing Mentors are college students, postsecondary faculty, and professionals in a variety of challenging academic and career fields. Many of the Mentors have disabilities themselves. As a Mentor, you can inspire and facilitate personal, academic, and professional achievements.

Application Process

Fill out the form below, then click submit. You will receive an email confirming receipt of your application. After review, you will be contacted by an AccessComputing staff person with next steps.

First Name *

Last Name *

Pronouns

Pronouns that should be used to refer to you (optional):

Please specify pronouns

Position

Organization

Address1 *

Address2

City *

State *

Zipcode *

Phone *

Email *

1. Are you currently a college student? If yes, what institution do you attend? What is your year in school and field(s) of study? *

2. Are you currently employed? If so, who is your employer? *

3. Please list any postsecondary degrees you have completed. *

4. Have you ever been a mentor? If so, please describe your experience(s). *

5. Have you had personal or professional experiences with disabilities that you could share with AccessComputing participants? If yes, please describe. *

6. Do you have any hobbies or special skills that you think will benefit AccessComputing mentees? *

7. Do you speak a language other than English? If yes, please list. *

8. Mentoring a young person is a big responsibility and can change the lives of both the mentor and the mentee. What do you hope to gain from the experience? What do you hope the mentee will gain? *

9. How did you hear about AccessComputing and our mentoring program?

References

Please list the names and contact information, including email addresses, for three references.

Reference 1: *

Reference 2: *

Reference 3: *

Participation Agreement

I have read and agree to the expectations listed for AccessComputing Mentors. I authorize AccessComputing to contact my references and process a background check. I agree to report any past convictions to AccessComputing at the time of application. Further, I agree to report to AccessComputing any future charge or conviction at the time it occurs. I will inform AccessComputing of any convictions or charges that relate to minors or vulnerable adults.

By submitting this form, you agree to these terms. *

I agree

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