Mentor Application

A New DREAM Mentor! Booyah!

Welcome to DREAM - it's a wacky and wild time, and we're psyched to have you on board. We hope these forms aren't too overwhelming, but they're necessary to ensure safety and fun for all.

Please Note: If you complete an application after April 30, 2022, your application will be processed over the summer for you to be ready come the 2022 Fall semester.

Contact Information

First Name *This question is required.

Last Name *This question is required.

If you entered your nickname above, what is your legal first name? Do you have any alternative legal names or spellings you've had since birth (including legally changed first and last names)?

**This information is only used to run state and federal background checks. *This question is required.

Please list any alternative legal names or spellings you've had since birth (including legally changed first and last names). *This question is required.

Date of Birth *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

If you said other, please specify. *This question is required.

If you said other, please specify.

Sex (as indicated on state or federal identification) -- DREAM recognizes that the gender marker on a state or federal
identification may not be reflective of your gender identity. Unfortunately, in order to conduct background checks using
state and federal databases, we often are limited in the gender identities we can select (female or male). What you list
here will be kept confidential and will not be used in any other circumstance outside of conducting a state and federal
background check. We know that sex and gender hold two different meanings, and we affirm that both are far more
expansive than the binaries listed in these databases could ever encompass. We commit to accepting, honoring, and
upholding your gender identity in DREAM spaces. *This question is required.

Street Address *This question is required.

Apt/Suite

City *This question is required.

Zip *This question is required.

School Email Address *This question is required. This question requires a valid email address.

Personal Email Address This question requires a valid email address.

Preferred Email Address *This question is required.

Primary Phone Number *This question is required. Please provide a 10-digit phone number including area code.
Enter numbers only. Formatting such as dashes will be added as you enter your phone number.

Secondary Phone Number

SSN: Please enter your Social Security Number (this information is required by the background check provider, Sterling Check, and is kept strictly confidential; if you do not have a SS#, please enter nine 9's). *This question is required.

If you said other, please specify.