Complete the form below, attaching additional pages if necessary.

Name:
Postal Address:
City:
State:
Zip Code:
Home Phone:
Email:

1. Are you currently a college student? If yes, what institution do you attend? What is your year in school and field(s) of study?
2. What is your occupation? Are you currently employed? If so, who is your employer? What is your position?
3. Please list any postsecondary degrees you have completed.
4. Have you ever been a mentor before? If so, please describe your experience(s).
5. Have you had personal or professional experiences with disabilities that you could share with participants? If yes, please describe.
6. Do you have any hobbies or special skills that you think will benefit our participants?
7. Do you speak a language other than English? If yes, please list.
8. Mentoring a young person is a big responsibility and can change the lives of both the mentor and the protégé. What do you hope to gain from the experience? What do you hope the protégé will gain?

List names and contact information for three references.

I have read and agree to the expectations listed for mentors as outlined in the Guidelines for Mentors publication. I authorize you to contact my references and process a background check.

Signature: ___________________________________________________

Congratulations on being accepted as a participant in the [name of program]! This program [description of program activities].

Mentoring

You will learn to use the Internet to explore your academic and career interests. You will communicate electronically from home using a computer, modem, software, an Internet network connection, and, if necessary, special adaptive technology. Frequent electronic communications and personal contacts will bring you together with mentors, who will promote your academic, career, and personal achievements. Mentors are college students and professionals in science, engineering, math, technology, and other fields, many with disabilities themselves.

Peer Mentoring

You will develop and practice communication and leadership skills by becoming a peer mentor for incoming participants. You will also recruit students into the program.

After you graduate from high school, you have the option of becoming a mentor. Mentor responsibilities encompass those of other participants, with the addition of the following:

• Share college experiences with new participants and give college and career transition advice based on these experiences.
• Mentor younger participants, and help monitor the mentoring discussion list to make sure all participants stay active and netiquette rules are followed, mainly by setting a good example.

Mentors

I'm sure you can think of one or more people in your life who have supplied information, offered advice, presented a challenge, initiated friendship, or simply expressed an interest in your development as a person. Without their intervention you might have remained on the same path, perhaps continuing a horizontal progression through your academic, career, or personal life.

Mentors are valuable resources to you. As guides, counselors, teachers, and friends, they inspire and facilitate academic, career, and personal achievements. Relationships developed with your mentors become channels for the passage of information, advice, opportunities, challenges, and sup-port with the ultimate goals of facilitating achievement and having fun.

Mentors offer the following:

• Information
  Mentors share their knowledge, experiences, and wisdom.
• Contacts
  Mentors provide valuable opportunities by facilitating academic, career, and personal contacts.
• Challenges
  Mentors stimulate curiosity and build confidence by presenting new ideas, opportunities, and challenges.
• Support
  Mentors encourage growth and achievement by providing an open and supportive environment.
• Goal Setting
  Mentors help you discover talents and interests and define and attain your goals.
• Advice
  Mentors guide you in reaching academic, career, and personal goals.
• Role Models
  By sharing their stories of achievement with you, mentors can become your role models.

To get to know mentors:

• Ask them about their personal interests and their interests and experiences in academics and careers.
• Introduce yourself. Share your personal, academic, and career interests and plans.
• Seek their advice about college preparation, entrance, and success. Ask about career options. Discuss disability-related accommodation issues.

Safety

Safety is an important issue for anyone using the Internet but even more so for minors. It is important that you learn how to identify potential danger and avoid it. Read Kids' Rules for Online Safety, published at SafeKids.com, www.safekids.com/kids-rules-for-online-safety.

Our program promotes group mentoring, in which groups of mentors and protégés discuss ideas and a staff member is always part of the discussion. You should not give out personal information to people you do not already know. Do not respond to electronic messages that you receive from anyone if you are not comfortable with the content. Immediately report offensive or troubling electronic mail messages to your parents and program staff.

"Netiquette"

Follow these electronic mail guidelines.

• Keep paragraphs in your messages short, and separate paragraphs with blank spaces.
• Avoid covering several topics in one message. Instead, send several messages. Then the receiver can respond to each topic separately.
• Use mixed upper- and lower-case letters. Avoid using control characters or special keys.
• It's friendly to begin a message with the real name of the person with whom you are corresponding. End the message with your real name.
• When replying to a message that was sent to you, include the email message to which you are replying. You may want to delete parts of it that do not relate to your reply.
• Do not use words others might find offensive. Avoid personal attacks. Don't engage in name calling.
• Do not participate in conversations that would not be acceptable to your parents and/or program staff.
• Do not engage in conversations that you are not comfortable with. Immediately report offensive or troubling electronic mail messages that you receive to [name and email address].
• Remember that an electronic mail message is easy for recipients to forward to others and, therefore, is not appropriate for very personal messages—it's more like a postcard than a sealed letter.
• Take advantage of the spell check feature.
• Review your message BEFORE you send it.

What Is an "Active" Participant?

We encourage you to pursue your interests in college studies and careers. Program activities are to help you in these efforts. To remain on the program team you must be "active." You are considered active if you do, at the minimum, all of the following:

• Read and respond to electronic mail messages at least once per week.
• Respond to every personal message sent to you by a mentor, participant, or staff member (response may be as simple as "Thanks for the information").
• Regularly communicate with participants. Send email messages to the group list at least once every two weeks.
• Send greetings to new participants and to other students with disabilities upon request.
• Use the computer and electronic resources in your regular academic classes (for example, use word processing software to write papers, or use electronic resources to obtain information to use in class papers, projects, or discussions).
• Attend program on-site events when possible.

Acknowledgment: These guidelines were adapted from the DO-IT publication Guidelines for DO-IT Scholars and Ambassadors at www.washington.edu/doit/guidelines-do-it-scholars-and-ambassadors. Permission is granted to reproduce this content provided the source is acknowledged.

What is a Mentor?

Most of us can think of people in our lives, more experienced than ourselves, who taught us something new, offered advice, presented a challenge, initiated friendship, or simply expressed an interest in our development as a person. They helped us negotiate an uphill path or find an entirely new path to a goal in our academic, career, or personal lives. They showed us a world larger than our neighborhood. They pointed out talents that we hadn't noticed in ourselves and stimulated ideas about what we might be able to accomplish. They nudged us when we needed a nudge.

Adult mentors are an important part of the [name of program] team. Mentors are college students, faculty, and professionals in a wide variety of career fields, many with disabilities themselves. Protégés are participants in the [name of program]. Most mentoring takes place on the Internet. Electronic communication eliminates the challenges imposed by time, distance, and disability that are characteristic of in-person mentoring. Frequent electronic communications and personal contacts bring participants together with mentors to facilitate academic, career, and personal achievements.

As a mentor you offer the following:

• Information
  Mentors share their knowledge, experiences, and wisdom.
• Contacts
  Mentors provide valuable opportunities by facilitating academic, career, and personal contacts.
• Challenges
  Mentors stimulate curiosity and build confidence by presenting new ideas, opportunities, and challenges.
• Support
  Mentors encourage growth and achievement by providing an open and supportive environment.
• Goal Setting
  Mentors help protégés discover talents and interests and define and attain their goals.
• Advice
  Mentors guide protégés in reaching academic, career, and personal goals.
• Role Models
  By sharing stories of achievement with protégés, mentors can become role models.

How to Be a Mentor

Program staff facilitate communication in small groups through the use of electronic discussion lists. For example, one group includes both mentors and protégés who are blind. They discuss common interests and concerns such as independent living, speech and Braille output systems for computers, and options for displaying images and mathematical expressions. Introducing protégés to mentors with similar disabilities is a strength of the program.

As a mentor, you are a valuable resource to your protégés. As a guide, counselor, and friend, you inspire and facilitate academic, career, and personal achievements. The developmental transitions faced by young people in each of these areas are enriched by your experience, wisdom, and guidance.

Your role as a mentor is a mix of friend and teacher. Relationships developed with your protégés become channels for the passage of information, advice, challenges, opportunities, and support, with the ultimate goals of facilitating achievement and having fun.

How is this accomplished? There are probably as many mentoring styles as there are personality types, and no one can be everything to one person. Each protégé benefits from contact with several mentors. The challenge and fun of mentoring is developing your own personal style for sharing the special strengths and skills you have to offer.

Following are a few suggestions for getting started and staying active as a mentor. Program staff welcome your ideas for suggestions to pass on to future mentors. Happy mentoring!!

Getting Started

To get started as a mentor:

• Introduce yourself and get to know each of your protégés. Mention personal, career, and education interests; disability; and involvement with science, technology, engineering, and math.
• Explore interests with protégés by asking questions, promoting discussion, and providing resources (especially those accessible on the Internet).
• Facilitate contact between students and people with shared interests or resources (e.g., professors, professionals).
• Encourage participation in our program's on-site events. Mentor-protégé relationships benefit from face-to-face contact!
• Remember that developing meaningful relationships takes time. Give yourself and your protégé ample room to get to know each other.

Staying Active

All DO-IT mentors are volunteers, and we know that mentoring takes a lot of time. The following are some guidelines to follow when considering whether you have the time and the willingness to be a mentor.

• Log on at least once per week and read and respond to electronic mail messages.
• Respond to every personal message sent to you by participants or program staff.
• Send a greeting to new participants.
• Communicate with other mentors; act as a resource when possible.
• Attend other program events whenever possible, and encourage other participants to attend events.

"Netiquette"

Follow these electronic guidelines.

• Be respectful of your protégés and their communication/personality styles. Ask if there is a way to accommodate them in the way you communicate.
• Avoid covering several topics in one message. Instead, send several messages so the receiver can respond to each topic separately.
• Use mixed upper- and lower-case letters. Avoid using control characters or special keys.
• Begin the text of your message with the real name of the person to whom you're writing, and end the text with your real name.
• Include all or parts of a mail message to which you are replying.
• Do not use words others might find offensive, and avoid personal attacks or name calling.
• Do not participate in conversations that would not be acceptable to the parents of your protégé and/or staff. Remember that program participants are minors!
• Do not engage in conversations that you are not comfortable with. Immediately report offensive or troubling electronic mail messages that you receive to [name and email address].
• Remember that an electronic mail message is easy for recipients to forward to others and, therefore, is not appropriate for very personal messages—it's more like a postcard than a sealed letter.
• Take advantage of the spell check feature.
• Review what you've written BEFORE you send it.

Keeping Our Young People Safe

The Internet is a sea filled with adventure. By sailing the waters we can explore the world, unlock mysteries, and meet new people. But like any sea, it has dangerous elements as well. Safety is an important issue for anyone using the Internet but even more so for minors. It is important that we teach our young people how to identify potential danger and avoid it.

Our program promotes group mentoring, in which groups of mentors and protégés discuss ideas and a staff member is always part of the discussion. Participants are told not to give out personal information to people they do not already know and not to respond to electronic messages that they receive from anyone if they are not comfortable with the content. They should immediately report offensive or troubling electronic mail messages to their parents and/or program staff.

For more information about the safety of minors on the Internet we suggest you read Kids' Rules for Online Safety, published at SafeKids.com, www.safekids.com/kids-rules-for-online-safety.

Acknowledgment: These guidelines were adapted from the DO-IT publication DO-IT Mentors: Helping Young People Prepare for Their Future at www.washington.edu/doit/do-it-mentors. Permission is granted to reproduce this content provided the source is acknowledged.

Name of Participant:

Parent/Guardian Name:

Parent/Guardian Postal Address:

Parent/Guardian Email Address:

Parent/Guardian Telephone Number(s):

I wish to participate in the [program name] online community. I have read the Protégé Guidelines, understand the information presented, and agree to the conditions for participation.

Signature of Participant and Date: ______________________________/____________

I have read the Protégé Guidelines, understand the information presented, and give permission for _____________________ [participant name] to participate in the [program name] online community. I understand that it is my responsibility to supervise my child's use of the Internet and enforce safety guidelines such as Kids' Rules for Online Safety, published at SafeKids.com, www.safekids.com/kids-rules-for-online-safety.

Name of Parent/Guardian: _________________________________________________

Signature of Parent/Guardian and Date: ___________________________/_________