Brother-2-Brother Mentoring Form PERSONAL INFORMATIONName* First Last Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail* EDUCATIONAL INFORMATIONHigh School* College / University Talents / SkillsTalents or skills that would be pertinent as a mentor in B2B: Mentoring / Leadership ProgramHave you ever been involved in a Male Mentoring? If so explain:Were you a 1st Generation college student? Yes No OTHERAvallability*Brother-2-Brother seeks mentors with male students committed to success through the initiative. In doing so, participants are expected to make a concerted effort to communicate and meet with each other at convenient times. Please indicate hours AVAILABLE:Authorization - Participants Signature*By signing below I verify the above information is true. Date MM slash DD slash YYYY
