Drury University

Master of Business Administration

Mentor Program Information Form

Note: Please complete the following information which will be used to help us to make appropriate matches.

Name:

Affiliation with Drury (check one)
	Alumnus Current Parent Friend Past Parent Trustee Other (If other, please specify)
Preferred Mailing Address
Preferred City
Preferred State
Preferred Zip
Preferred Telephone
Email
Organization Name
Title/Position

Which of the following best describes your professional interest or industry? (Check all that apply)

Accounting Advertising Banking Communications Economics Entertainment/Sports Information Technology	Finance Health Care Human Resources Management Marketing Market Research Other
(If other, please specify)

How many years of experience do you have in this profession or industry?
	None 1 to 3 years 4 or more years

Would you prefer to be matched with a mentee who is:
	Male Female Either male or female would be fine

Are you able to allot at least 10 hours over an approximate 10 month period:
	Yes No Unsure

Please add a brief bio to ensure the best match:

Do you have any other preferences or interests that would help us make a good match?