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Asian American Cultural Center

Office of the Dean of Students

University of Illinois at Urbana-Champaign

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AACC Mentoring Program: Student Application

Personal and Contact Information

Name:

E-mail:

Phone:

Local Address:

Ethnicity:

Gender:

Hometown:

Generation: (first being immigrant)

Career and Academic Information

Year in School:

Major:

Minor: (if applicable)

Career Goal:

What organizations are you involved with on campus? (if applicable)

If you have problems with this application or have questions concerning the Mentoring Program please contact Linda Luk.

Asian American Cultural Center :: 1210 West Nevada Street :: Urbana, IL 61801 :: 217-333-9300 :: aacc@uiuc.edu

Office of the Dean of Students :: Student Affairs :: University of Illinois at Urbana-Champaign :: © 2006-2007