First Name *

Last Name *

Pronouns *

Another

Cell Phone *

MIT ID Number *

MIT Email *

Class Year: *

Course/Major (select all that apply) *

Course 1 – Civil and Environmental Engineering Course 2 – Mechanical Engineering Course 2A – Mechanical Engineering Flex Course 2OE – Mechanical and Ocean Engineering Course 3 – Materials Science & Engineering Course 3A – Materials Science & Engineering Flex Course 3C – Archeology and Materials Course 4 – Architecture Course 4B – Art & Design Course 5 – Chemistry Course 5-7 – Chemistry and Biology Course 6-1 – Electrical Science and Engineering Course 6-2 – Electrical Engineering and Computer Science Course 6-3 – Computer Science and Engineering Course 6-7 – Computer Science and Molecular Biology Course 6-1/8 – EE/Physics Flex Course 6-14 – Computer Science, Economics and Data Science Course 7 – Biology Course 8 – Physics Course 9 – Brain & Cognitive Sciences Course 10 – Chemical Engineering Course 10B – Chemical-Biological Engineering Course 10-ENG – Chemical Engineering Flex Course 11 – Urban Studies & Planning Course 11-6 – Urban Studies & Planning with Computer Science Course 12 – Earth, Atmospheric, & Planetary Sciences Course 14-1 – Economics Course 14-2 – Mathematical Economics Course 15-1 – Management Course 15-2 – Business Analytics Course 15-3 – Finance Course 16 – Aeronautics & Astronautics Course 16-ENG – Aeronautics & Astronautics Flex Course 17 – Political Science Course 18 – Mathematics Course 18C – Mathematics with Computer Science Course 20 – Biological Engineering Course 21 – Humanities Course 21A – Anthropology Course 21E – Humanities & Engineering Course 21G – Global Studies and Languages Course 21H – History Course 21L – Literature Course 21M-1 – Music Course 21M-2 – Theatre Arts Course 21S – Humanities & Science Course 21W – Writing Course 22 – Nuclear Science & Engineering Course 22-ENG – Nuclear Science & Engineering Flex Course 24-1 – Philosophy Course 24-2 – Linguistics CMS – Comparative Media Studies STS – Science, Technology & Society WGS – Women’s & Gender Studies

Minor (select all that apply)

Research Interest or Academic Interest *

Race/Ethnicity (select all that apply) *

Asian Middle-Eastern Black / African-American / Caribbean-American / African Hispanic / LatinX Native American / American Indian / Native Alaskan / Pacific Islander White / Caucasian / European Another racial identity Choose not to respond

If another, please specify:

These next two questions are optional to answer. These questions help us with the matching process along with end of year reporting.

Gender:

My gender is:

Are you transgender:

Do you speak a language other than English? If yes, please list the language(s) *

Please indicate which of these identities apply to you, if any:

First Generation (those whose parents' highest level of education is a high school diploma or less) Low Income (an individual whose family's taxable income for the preceding year did not exceed 150 percent of the poverty level amount) Person with a disability LGBTQIA+

Are you a returning protégé? *

Do you wish to continue your e-mentoring relationship with the same mentor as last year? (if they are available - please complete the application fully in case they are not) *

Please rate the value of each of these benefits connected to mentoring in the order of their importance to you (1 being the most important) *

1 -

2 -

3 -

4 -

5 -

Please list three goals you would like to get out of this mentorship experience:

Goal 1 *

Goal 2 *

Goal 3 *

What do you expect to gain by participating in EMAP? *

Please rank the following companies based on interest *

1 -

2 -

3 -

4 -

5 -

If your mentor is an MIT alum, would you prefer to be paired with a Black Alumni of MIT (BAMIT) or Latino Alumni of MIT (LAMIT) affiliate? *

My photo release status is: *

Please create and confirm your account password for future login:
(Your Username will be your Email)

Password _{must be between
8 and 20 characters}

Confirm Password

E-Mentoring Mentor Advocate Partnership Program
Participation Agreement

The Massachusetts Institute of Technology Office of Minority Education (OME) appreciates your willingness to participate in the E-Mentoring Mentor Advocate Partnership Program (EMAP). OME promotes respect and responsibility for protégés, mentors, IACME partners, staff and other stakeholders. As such, it is crucial that a safe and respectful environment is established for both protégés and mentors.

All EMAP Program participants are expected to read, adhere to and sign below acknowledging their commitment to fulfilling program expectations. By participating in EMAP, I commit to:

Program Expectations

Connecting with my Mentor/Protégé once every month, from September 2024 to May 2025. Being proactive with scheduling monthly interactions and also promptly responding to communication
Submitting monthly online check-in forms, from September 2024 to May 2025
Engaging Office of Minority Education EMAP program staff as needed
Attending End of Year Celebration event (if available)
Submitting End of Year survey
Abstaining from conduct considered improper and inappropriate. The prohibited conduct that is listed below is not an exhaustive list, as we cannot, with foresight, determine inappropriate conduct under every circumstance. Moreover, we do not limit the right to discharge participants for conduct that is not listed below.
- Knowingly disseminate or transmit content that is unlawful, harmful, threatening, abusive, harassing, tortuous, libelous, pornographic or invasive of another’s privacy
- Knowingly disseminate or transmit content that infringes on any patent, trademark, trade secret, copyright or other proprietary rights of any other party
- Knowingly disseminate or transmit any unauthorized advertising, promotional materials and goods, chain letters, spam, junk mail, or any other type of mass unsolicited email to others who have not agreed to receive such materials
- Impersonate another person or entity
- Stalk or harass another protégé or mentor
- Knowingly disseminate, transmit or make otherwise available any materials that contain software viruses, computer code, files or programs designed to interrupt, destroy or limit the functionality of any computer software or hardware
- Collect or store personal data about other protégés or mentors
- Knowingly disseminate or transmit illegal and illegally-obtained materials
- Fraternize outside of the professional mentor and protégé relationship
- Share confidential information

I agree to the code of conduct and to fulfill the EMAP program expectations listed above for the 2024-2025 session

EMAP - 2024-2025 SESSION

Protégé Application

CONTACT

INFORMATION

Mentoring agreement

E-Mentoring Mentor Advocate Partnership Program
Participation Agreement

EMAP - 2024-2025 SESSION

Protégé Application

CONTACT

INFORMATION

Mentoring agreement

E-Mentoring Mentor Advocate Partnership ProgramParticipation Agreement

E-Mentoring Mentor Advocate Partnership Program
Participation Agreement