2023 Mentee Application - Students - Multicultural & Diversity Programs

Future Students

Undergraduate Students

Graduate Students

Parents & Family

Alumni

Faculty & Staff

Researchers

Patients

Colleges & Schools

Please complete the following application to join the Blazer Male Excellence Network

Participation requirements for the BMEN program include:

Attend Weekly BMEN AAS 150 Class on Fridays at 3 p.m. during the Fall Semester
Attend weekly study hours
Participate in month BMEN programming (workshops, outings, etc.)
Maintain weekly contact with assigned mentor
Have monthly face to face meetings with your BMEN Mentor
Meet with Peer Academic Coach
Check UAB Blazer email account daily
Establish and maintain an academic graduation plan and submit for approval to BMEN staff every mid-term of each semester

Please answer all questions in complete sentences. Failure to do so will result in an incomplete application.

Preferred Name

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Last Name

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Date Of Birth

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Email Address(*)

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Phone Number(*)

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Parent/Guardian Full name

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Permanent Address (include city, state and zipcode)

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Will you live on campus in the fall?

Yes

Other (Please Specify)

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Other

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High School Name

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High School Location

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High School Graduation Date

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List any allergies

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List any dietary restrictions(*)

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List any disability requirements(*)

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What is your major? Minor?

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What are your career aspirations?

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Please list your participation in clubs, group sports, leadership roles, etc.

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Please list your hobbies

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How did you learn about the BMEN program?

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Why are you interested in joining the BMEN program?

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What are your expectations for your first year at UAB?

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Do you currently have a mentor? If yes, please briefly describe how you were matched and your relationship.

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How can your BMEN mentor assist in your success at UAB?

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Will you attend the BMEN Enrichment Week activities August 13-20, 2023?

Yes

Unsure

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I understand that in order for my application to be considered complete, I must answer all questions in complete sentences.(*)

I have answered all questions in complete sentences.

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I understand that in order to be matched with a mentor in the BMEN program, I must register for the BMEN Class, AAS 150: Let’s BMEN(*)

I understand.

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Are you a human?(*)

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Blazer Male Excellence Network Mentee Application