Wayne State University
School of Business

Executive Mentor Program

Mentor Application

The information provided is strictly confidential and will be used for the sole purpose of matching you with a freshman student participating in the WSU School of Business Administration Executive Mentor Program.

Mentor Information

First Name *

Middle Initial

Last Name *

Daytime Telephone

Evening Telephone

Email

Company Information

Company Name

Address

City

State

Zip Code

Please indicate the method of contact you prefer:

Telephone

Email

Both

Please indicate your current employment title:

Interests

Please indicate the area(s) in which you would be most interested in providing mentorship:
(Check all that apply)

Accounting

Business Logistics

Finance

Information System Management (ISM)

Management (including Human Resource Mgmt.)

Marketing (including Advertising)

Are you willing to mentor two students? (check one)

Yes

No

In The Future

Please include any additional information that you feel the School should know in identifying the student for you. (optional)

Wayne State UniversitySchool of Business

Executive Mentor Program

Mentor Application

Wayne State University
School of Business