First Name
Last Name
Phone
Email
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Street Address
Street Address Line 2
City
State/Province
Zip Code

Do you have experience as a mentor? --None-- Yes No
Do you have any managerial experience? --None-- Yes No
Are you familiar with basic IT tools, such as Microsoft Office and Google Workspace? --None-- Yes No
Do you have access to a computer and a reliable internet connection? --None-- Yes No

Have you participated in an online course before? --None-- Yes No
Have you ever had a mentor yourself? --None-- Yes No
Do you have experience with Coursera or online training programs? --None-- Yes No
Do you have time to meet the commitments expected of a UTH mentor?
- 30-60 minutes weekly to meet with the student over at least six months.
- 15 minutes per week for some basic admin.
- 30-60 minutes every 1-2 months for a discussion circle with other mentors. --None-- Yes No

Please describe your professional background or professional skills
Why do you want to volunteer as a mentor with UTH?
Mentor