First Name * Last Name * Student ID * Applicant Status * New to the Mentor Program Returning Student Participant If returning, would you like to request the same mentor you have now or a new one? * Keep Same Mentor New Mentor Name of Previous Mentor * UK Email Address * Cell Phone Number * Preferred Contact Method Email Cell Campus Address Home Street Address Home Street Address Line 2 Home City Home State / Province Home ZIP / Postal Code Home Country Geographic Regions of interest after graduation New England: CT, ME, MA, NH, RI, VT Mideast: DE DC, MD, NJ, NY, PA Great Lakes: IL, IN, Ml, OH, WI Plains: IA, KS, MN MO, NE, ND, SD Southeast: AL, AR, FL, GA, KY, LA, MS, NS, SC, TN, VA, WV Southwest: AZ, NM, OK, TX Rocky Mountain: CO, ID, MN, UT, WY Far West: AK, CA, HI, NV, OR, WA Outside US Undergraduate Degree Major/Interest Biosystems Engineering Chemical Engineering Civil Engineering Computer Engineering Computer Science Electrical Engineering Materials Engineering Mechanical Engineering Mining Engineering Current Class Status Freshman Sophomore Junior Senior Expected Graduation Semester and Year Are you considering Professional School? Yes No Activities as an Undergraduate Athletics/Cheerleading/Club Sports Engineering Student Council Engineering Organizations Greek Life Marching Band UK Student Government Residence Life ROTC Study Abroad Undergraduate Research Other If you participated in Engineering Organizations, which ones: If you participated in Other organizations, please list them Career Areas/Industry Sectors of Interest to you AgricultureAutomotiveAerospaceBiomedical EngineeringChemical EngineeringCivil EngineeringComputers, Software, Information TechnologyComputer ScienceConsultingConsumer GoodsConstructionData, StatisticsDesign EngineeringEducationElectronicsElectrical Computer EngineeringEnergy, Gas, Oil, ElectricEngineeringEntrepreneur, Business OwnerEnvironmentalFinancial ServicesGovernment, DefenseIndustrialLawManagementManufacturingMaterialsMechanical EngineeringMedical DevicesMedicine, HealthcareMining EngineeringPharmaceuticalsSound, CommunicationsStructuresTransportation, LogisticsOther (Please describe below) Other Area of Expertise/Industry Sectors Which area would you prefer your match to be based on? Undergraduate Major, Interest Home/Permanent address Geographic Region of Interest Student Involvement, Activities Ethnicity, Gender Industry Sector of Interest I verify that I have read the Mentor Program handbook and agree to the expectations outlined. Yes I understand that as the student, I am to assume primary responsibility for initiating mentoring once I am matched with a mentor. Yes Submit