Mentor Interest Form (Pathways) First Name(Required)Last Name(Required)Preferred Name/Nickname(Required)Alpha(Required)-please select an option-AlphaAlpha DeltaBetaBeta DeltaChiChi DeltaDelta DeltaEpsilonEpsilon DeltaEpsilon TauEtaEta DeltaGammaGamma DeltaIotaIota DeltaKappa DeltaLambda DeltaMuMu DeltaNuNu DeltaNu TauOmicronOmicron DeltaPhiPhi DeltaPiPi DeltaPi TauPsiPsi DeltaRhoRho DeltaSigmaSigma DeltaTau DeltaTheta DeltaUpsilon DeltaXiXi DeltaZeta DeltaGraduation Year(Required)- please select an option -1950195119521953195419551956195719581959196019601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024202520262027202820292030Please list the city and state you currently reside in(Required)CityState Add RemoveIf you have multiple answers, please use the plus button to add a new row for a second city and state. Email(Required)Phone(Required)Phone Type(Required) Home Mobile Work Have you been matched with a Chi Psi mentee before?(Required) Yes No How many mentees are you willing to be matched with?(Required) 1 2 3 What type of mentee do you prefer?(Required) An active from my Alpha An active from my region No preference Please note, while we try to take all preferences in account, sometimes matches do not 100% fit this because I can't and I'm trying my bestUndergraduate Majors(Required)Current Employer(Required)If retired, write most notable or recent employer/title.Current Job Title(Required)Describe your main professional area(s) of expertise.(Required)(This can include previous jobs held).Which areas are you comfortable providing mentoring support in?(Required) General Professional Guidance Resume Review Interview Practice Internship/Job Advice Post-grad opportunities Better understanding a specific industry or field Life Coaching Select AllSelect all industries/fields you feel comfortable mentoring(Required) Agriculture Agriculture - Executives/Managers/Supervisors Agriculture - Farming Agriculture - Fish & Wildlife Agriculture - Forestry/Conservation Agriculture - Landscape/Horticulture Agriculture - Other Agriculture - Ranching Architecture & Construction Architecture & Construction - Architect Architecture & Construction - Contractor Architecture & Construction - Developer/Builder Architecture & Construction - Drafting/Design/CAD Operator Architecture & Construction - Executives/Managers/Supervisors Architecture & Construction - Other Architecture & Construction - Project Manager/Supervisor Architecture & Construction - Urban Design/Planning Art & Design Art & Design - Artist/Painter/Sculptor Art & Design - Clothing/Fashion/Jewelry Art & Design - Commercial/Artist/Graphic Design/Illustrator Art & Design - Curator/Conservator Art & Design - Executives/Managers/Supervisors Art & Design - Interior Décor/Design Art & Design - Museums Art & Design - Other Arts & Entertainment Arts & Entertainment - Dancers/Choreographers Arts & Entertainment - Designers Arts & Entertainment - Directors/Producers Arts & Entertainment - Executives/Managers/Supervisors Arts & Entertainment - Other Arts & Entertainment - Performers/Actors/Musicians Arts & Entertainment - Radio/Cable/TV/Film Business Business - Account Executive/Manager Business - Accounting - Corporate Business - Accounting - Private Practice Business - Accounting - Public Business - Administration & Support Staff Business - Buying/Purchasing/Inventory Management Business - CEO/COO/President/Board Member Business - Consulting Business - Customer Service Business - Economist/Market Research Business - Executives/Managers/Supervisors Business - Human Resources/Personnel/HR Business - Import Export/International Trade Business - Independent Contractor/Freelancer Business - Labor Unions Business - Other Business - Owner/Partner/Entrepreneur Business - Planning/Strategy Business - Self-Employed Business - Vice-President/Director/Manager Community & Social Services Community & Social Services - Child/Family/School Services Community & Social Services - Executives/Managers/Supervisors Community & Social Services - Medical/Public Health Community & Social Services - Mental Health/Counseling Community & Social Services - Other Community & Social Services - Social Welfare Community & Social Services - Substance Abuse Education Education - Administration, College/University Education - Administration, K-12 Education - College Instructor Education - College Professor Education - Librarian/Library Science/Archivist Education - Other Education - Special Education Education - Student, College Education - Student, Graduate/Post-graduate Education - Support Staff Education - Student Support Services Education - Teacher/Instructor/Lecturer Education - Teacher, Middle & High School Education - Teacher, Pre-school & Elementary Energy Energy - Extraction/Mining Energy - Field Services Energy - Generation/Utility Energy - Oil & Gas Energy - Other Energy - Pipeline/Distribution Energy - Refining/Processing Engineer Engineer - Aerospace/Aeronautical Engineer - Biomedical Engineer - Chemical Engineer - Civil Engineer - Electrical/Electronic Engineer - Environmental Engineer - Executives/Managers/Supervisors Engineer - Industrial/Manufacturing Engineer - Marine & Ocean Engineer - Mechanical Engineer - Mining/Nuclear/Petroleum Engineer - Other Engineer - Technician Finance Finance - Analyst Finance - Banking Finance - Corporate Finance - Executives/Managers/Supervisors Finance - Financial/Investment Advisor Finance - Insurance Finance - Investment Manager Finance - Other Finance - Stockbroker/Brokerage/Investments/Securities Finance - Venture Capital/Private Equity Government Government - Administration & Support Staff Government - Appointed Official Government - City/County Government - Civil Service Government - Elected Official/Politician Government - Executives/Managers/Supervisors Government - Federal Government - Foreign Service/Consular Government - International Government - Lobbying/Advocacy Government - Other Government - State Health Health - Administration & Support Staff Health - Audiology/Audiologist Health - Chiropractor Health - Dentistry - General Health - Dentistry - Specialist Health - Dentistry - Technician/Hygienist/Assistant Health - Executives/Managers/Supervisors Health - Nurse Health - Nutritionist/Dietitian/Wellness Health - Optometry/Ophthalmology Health - Other Health - Patient Support/Aide Health - Pharmacist/Pharmacologist Health - Physical/Occupational Therapy/Rehabilitation Health - Physician/Surgeon Health - Physicians Assistant/Nurse Practitioner Health - Psychiatry/Behavioral Science Health - Psychology/Therapy/Counseling Health - Speech Language/Pathology Health - Technicians/Technologists Health - Technology/Medical Devices Health - Veterinary Medicine Hospitality Hospitality - Amusement/Recreation Hospitality - Chef/Cook Hospitality - Executives/Managers/Supervisors Hospitality - Hotels/Resorts Hospitality - Other Hospitality - Restaurants/Food Service/Catering Hospitality - Staff Hospitality - Travel/Tourism IT IT - Administration & Support Staff IT - Software Engineer/Developer/Programmer IT - Business/Systems Analyst IT - Computer/Network Operations IT - Consultant IT - Database Design/Management IT - Executives/Managers/Supervisors IT - Information Technology/Computer Science IT - Network/Infrastructure/Hardware IT - Other IT - Program/Product/Project Manager IT - Technicians/Technical Support IT - Web/Internet/Social Media/Design Legal Legal - Administration & Support Staff Legal - Attorney - Bankruptcy/Consumer Law Legal - Attorney - Business & Corporate Legal - Attorney - Civil Rights Legal - Attorney - Criminal Defense Legal - Attorney - Employment/Labor Legal - Attorney - Environmental Legal - Attorney - Estate Law/Planning Legal - Attorney - Family & Divorce Legal - Attorney - General Practice Legal - Attorney - Government Legal - Attorney - Healthcare Legal - Attorney - Immigration Legal - Attorney - Intellectual Property/Patent Legal - Attorney - International Legal - Attorney - Litigation Legal - Attorney - Other Legal - Attorney - Personal Injury Legal - Attorney - Prosecution Legal - Attorney - Taxation Legal - Judiciary - Federal Legal - Judiciary - Local Legal - Judiciary - Other Legal - Judiciary - State Legal - Other Legal - Paralegal Legal - Services Manufacturing Manufacturing - Chemical Processing Manufacturing - Executives/Managers/Supervisors Manufacturing - Maintenance/Repair Manufacturing - Materials Management Manufacturing - Other Manufacturing - Quality/Process Analysis & Control Manufacturing - Technicians/Production Support Marketing Marketing - Direct Marketing/Direct Response Marketing - Executives/Managers/Supervisors Marketing - Other Marketing - Product/Consumer Marketing Marketing - Promotion/Event Planning Marketing - Public Relations Marketing - Research/Analysis/Analytics Marketing - Social Media/Mobil/Internet Media Media - Advertising Media - Communications Media - Executives/Managers/Supervisors Media - Film/Videography Media - Internet/E-commerce Media - Journalist/Reporter Media - Other Media - Photography Media - Publishing Media - Telecommunications Media - Writer/Author/Editor Military Military - Civilian Administration & Support Staff Military - National Guard Military - Other Military - US Air Force Military - US Army Military - US Coast Guard Military - US Marines Military - US Navy Non-profit Non-profit - Administration & Support Staff Non-profit - Development Officer/Fundraiser Non-profit - Executives/Managers/Supervisors Non-profit - Other Non-profit - Philanthropist Non-profit - Volunteer Protective Services Protective Services - Correctional Officers Protective Services - Executives/Managers/Supervisors Protective Services - Fire/Ambulance/Rescue Protective Services - Fish & Game Wardens/Forestry Service Protective Services - Immigration/Customs Protective Services - Law Enforcement Protective Services - Other Protective Services - Paramedic/EMT Protective Services - Private Detectives/Investigators Protective Services - Security Real Estate Real Estate - Appraisers Real Estate - Broker/Agent Real Estate - Building/Property/Community Management Real Estate - Executives/Managers/Supervisors Real Estate - Investments/Holdings Real Estate - Other Religion Religion - Administration & Support Staff Religion - Executives/Managers/Supervisors Religion - Non-Clergy Religion - Other Religion - Minister/Pastor/Priest Retail Retail - Executives/Managers/Supervisors Retail - Merchandising/Merchandiser Retail - Other Sales [sales] Sales - Advertising/Media Related Sales - Business Development Sales - Consumer Sales - Executives/Managers/Supervisors Sales - Industrial Sales - Other Sales - Product/Client Specialist & Support Sales - Retail Science Science - Aerospace/Aeronautical Science - Anthropology/Archeology Science - Astronomy/Astrophysics Science - Biology/Biologist/Biochemistry Science - Chemistry Science - Computing Technology Science - Environment/Environmental Science - Executives/Managers/Supervisors Science - Geologist/Geology Science - Mathematics/Statistics/Analytics Science - Other Science - Physicist/Physics Science - Political/Social Science Science - Research and Development Science - Social/Sociology Services Services - Beauty/Fitness Services - Childcare/Daycare Services - Cleaning/Restoration Services - Consumer Services - Executives/Managers/Supervisors Services - Maintenance/Repair Services - Other Services - Personal Services - Professional/Business Sports & Athletics Sports & Athletics - Coach/Referee/Trainer Sports & Athletics - Executives/Managers/Supervisors Sports & Athletics - Other Sports & Athletics - Professional Athlete Sports & Athletics - Recreation Trade Trade - Carpentry/Electrical/Plumbing/Welding Trade - Electrical/Electronics Repair Trade - Licensed/Certified/Skilled Trade - Mechanical/Repair Trade - Other Trade - Technicians Transportation Transportation - Airline/Pilot/Crew Transportation - Aviation/Aerospace Transportation - Delivery/Distribution Transportation - Design/Planning Transportation - Executives/Managers/Supervisors Transportation - Logistics/Supply Chain/Distributor Transportation - Marine Transportation - Other Transportation - Railroad Transportation - Ship Captain/Officers/Crew Transportation - Trucking/Shipping Describe any other ways you'd feel comfortable supporting an undergraduate Chi Psi(Required)Provide a brief (4-5 sentence) bio that we can share with undergraduate(s) you may be matched with(Required)LinkedIn Profile (if applicable)