Become a Mentor

Looking to make an impact?

Please answer these questions carefully. They will be used to skillfully match you with a student who has like interests. All responses will be kept confidential and files will be kept secure.

You can also download the application form as a PDF. The completed application can be submitted via emailor printed and mailed to the contact below.

Name(Required)
Pronoun(Required)
Hidden
Gender Identity(Required)
Are you an Adelphi University Employee?(Required)
What is your preferred method of communication?(Required)
Indicate your grade level/cohort preference(Required)
Indicate your population preference
Select all that apply
Write a brief statement on why you have chosen to participate in the Adelphi University Mentoring Program for Undergraduate Students of Color/Veterans/First Generation Students/LGBTQ+ Students.
Have you been convicted of a crime in the last 7 years?(Required)
Educational Background(Required)
What days of the week are you available to volunteer as a Mentor? (Check all that apply)(Required)
What is the best time for you to Volunteer? (Check all that apply)(Required)

Please list two references (please include at least one personal friend and one work reference) Note: letters of recommendation are not necessary, only contact information:

Reference 1 Name(Required)
Reference 1 Address(Required)
Reference 2 Name(Required)
Reference 2 Address(Required)
Do you speak a foreign language?(Required)
Digital Signature(Required)
This field is for validation purposes and should be left unchanged.
Chotsani Williams West
Assistant Vice President of Diversity Equity Inclusion and Belonging
Office of Diversity, Equity, Inclusion and Belonging
Contact
E-mail
cwest@adelphi.edu
Phone Number
516.877.3182
Fax
516.877.3239
Location
Nexus Building 312