1.	First name:*

2.	Last Name:*

3.	Student ID number (ex. 0123456):*

4.	Email address:*

5.	Year:*
	-- Please Select --FreshmanSophomoreJuniorSeniorGraduate Student

6.	Expected graduation date:* (include MONTH and YEAR, for example "December 2011" or "May 2012")

7.	Major:*
	-- Please Select --AccountingAdvertisingArchitectureArchitectural TechnologyBehavioral SciencesBusiness AdministrationClinical NutritionCommunication ArtsComputer GraphicsComputer ScienceCriminal JusticeEducationElectrical and Computer EngineeringEnergy ManagementEngineering ManagementEnglishEnvironmental TechnologyGraphic DesignHospitality ManagementHuman Resource ManagementInformation, Network, and Computer SecurityInformation TechnologyInterior DesignLife SciencesMechanical EngineeringMental Health CounselingNursingOccupational TherapyOsteopathic MedicinePhysical TherapyPhysician AssistantPsychologyTelecommunications Network Management

8.	Cocurricular activities (check all that apply):*
	Academic Honor Society    ADDO    Allied Health Life Science Organization (AHLSO)    American Institute for Architecture Students (AIAS)    American Medical Student Association (AMSA)    American Society of Mechanical Engineers    Asian Medical Humanitarian Association    Association of Computing Machinery    Bear Hug Club    Behavioral Science Club    Biomedical Research Society    Calvary Christian Fellowship    Campus Programming Board (CPB)    Campus Slate (student newspaper)    Circolo Italiano    Community Services    Computer Graphics Club    Computer Programmers' Consortrium (CPC)    Construction Management Association of America    Dance Club    Dhadkhan Dance Team    Fraternity or Sorority    G.I.V.E. Club    GAM    IEEE    Interior Design Club    International Students Association    Intramural/Varsity Sports    Jewish Student Union    Law Club    Music/Theater    Muslim Student Association    National Society of Black Engineers    Newspaper    NYIT Choir    NYIT Chronicle    Orientation Staff    Orthodox Christian Club    Peer Advisor    Peer Counselor/Tutor    Physical Therapy Association    Physician Assistant Society    Radio Station    Residential Life Staff    Society of Automotive Engineers    Society of Hosteurs    STAND    Student Government    Student Nursing Association    Student Occupational Therapy Association    Student Professional Organization    Student Programming Association    Student Talent Union    Student Union of Contemporary Art    Sustainability Club    Unite for Site    WNYT    Women's Association

9.	Select your Areas of Interest (select your top 4):*
	Accounting    Advertising    Architecture    Behavioral Science (Psychology, Sociology, Social Work)    Biology    Bioinformatics    Biomedical Engineering    Business    Chemistry    Computer Graphics and Animation    Communication Arts    Computer Science    Counseling (School, Mental Health, and Human Relations)    Criminal Justice    Culinary Arts    Economics    Education/Teaching    Electrical and Computer Engineering, Electronics, and Engineering Management    Energy Management    English    Entrepreneurship    Environmental Technology    Film    Fine Arts    Finance    Graphic Design    Health and Nutrition    Hospitality Management    Human Resources Management    Information Technology    Interior Design    International Business    Law    Management    Management of Information Systems    Marketing    Mechanical and Aerospace Engineering    Media Management    Non-Profit    Nursing and Physician Assistant    Occupational Therapy/Physical Therapy    Osteopathic Medicine    Political Science    Print and Electronic Journalism/Writing/Publishing    Public Relations    Radio/TV Production    Technical Writing    Telecommunications    Urban and Regional Design    Web Development

10.	What activities do you wish to participate in (check all that apply)?*
	Networking with Alumni (in person, email, webcam)    Job Shadowing    Informational Interviews    Mock Interviews    Resume/Cover letter Critiques    Internship/Job Search Assistance    General Career Guidance

11.	In 200 words, please tell us why you should be selected to participate in the mentor program? *