Huskie-2-Huskie Student Form

Huskie-2-Huskie Mentoring Program Student Application Please complete this application in full. You will be contacted by the NIU Alumni Association when a suitable Huskie mentor has been identified. Thank you for your participation in this valuable Alumni program! Select from the items below.         First Name: Last Name: Email: Campus Address 1 (if none, type N/A) Campus Address 2 City: State: Please Choose Not in US AE AK AL AP AR AS AZ BC CA CM CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MB MD ME MI MN MO MS MT NC ND NE NF NH NJ NM NS NV NY OH OK ON OR PA PR RI SC SD SK TN TX UT VA VI VT WA WI WV WY ZZ Zip: Home Phone Cell Phone Permanent Address 1 Permanent Address 2 Anticipated Graduation Year Major Expected Degree Five Areas to Learn From Mentor Geographical Area of Interest Occupational Area of Interest Specific Company of Interest Additional Comments

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