Mentee Application

Thank you for your interest in being a participant in the CSD REACHing Peers Program! Please take a few minutes to fill out our application so we can learn more about you and help match you with a REACH Mentor.

Section 1

Bio/Demographic Information
Name(Required)
UConn Email(Required)
Include State and/or Country if you are an international student
Year Standing at UConn:(Required)
Semester and Year
Are you a transfer student?(Required)

Section 2

Please tell us a little more about yourself and why you would like to be a part of the CSD REACHing Peers Program!

Section 3

Responses in this section will provide us with information to help in matching you with a suitable REACH Mentor!
What are your interests and/or hobbies?(Required)

Section 4

This section will help us to better understand you and your disability type. All information provided on this form will remain confidential and will only be viewed by necessary CSD Staff.
What is your Disability Type?(Required)
With what type of disclosure of your disability type would you feel most comfortable?(Required)

Section 5

The goal of REACHing Peers Socials would be to help create a larger network of peers and a greater sense of community for students participating in the program. This section will help us get a better idea of how best to organize these events for the mentors and mentees.
Would you be interested in attending CSD REACHing Peers Socials with others involved in the program?(Required)

Please provide us with any ideas for events/activities you might have

Section 6

Please let us know your honest feedback so we can improve our program!
How did you hear about the CSD REACHing Peers Program?(Required)
This field is for validation purposes and should be left unchanged.