Mentees
Just copy and paste this info sheet, then send a completed copy to us at outreach.peer.mentors@dartmouth.edu if you’d like to become a mentee!
MENTEE Questionnaire
The LGBTQ Peer-Mentor Program trains current Dartmouth students as mentors to help peers develop a positive LGBTQ identity while successfully adapting to life at Dartmouth. The program is here to help students explore their personal interests, take advantage of campus resources, and find their own sense of community.
Mentees are matched with mentors based on similar academic interests, extracurricular activities, and geographic location.
Please note that all answers are strictly CONFIDENTIAL.
Basic Information
PREFERRED NAME:
AGE:
GENDER IDENTITY:
YEAR:
EMAIL:
HINMAN BOX:
PHONE:
Where are you from?:
Ethnicity (check all/any boxes that apply)
__Asian Pacific Islander
__Native American
__Latino/a
__African American/Black
__Caucasian
__Other (please specify): ____________
General Questions
Please share or describe your sexual orientation, if you can:
How out would you characterize yourself? (Please check the box that applies):
__Not out at all
__Out to yourself, but no one else
__Out to select few
__Out to most people
__Completely out
Would you characterize yourself as confused, uncomfortable, worried, depressed, or excited about your sexuality (Please check all that apply):
__Not confused __Not uncomfortable
__Somewhat confused __Somewhat uncomfortable
__Very confused __Very uncomfortable
__Not worried __Not depressed
__Somewhat worried __Somewhat depressed
__Very worried __Very depressed
__Not excited
__Somewhat excited
__Very excited!
What are some of the reasons you seek a mentor and what are some of the goals you hope to accomplish (the more specific, the better!)?
What are the three most important activities/groups on campus with which you are involved?
Is there anything else we should know in regard to matching you with an Outreach mentor?