First (Preferred) Name *

Last Name *

Pronouns *

Another

Cell Phone *

MIT ID *

I am a first-year student and confirm that I am part of the Class of 2028 *

MIT Email *

Secondary Email

Intended 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

Research Interest *

Advisor

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:

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:

Religious affiliation (select all that apply) *

If another, please specify:

Hometown Country *

Hometown State:

Hometown City *

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

Arts (visual, performing, craft, culinary, etc.):

Sports:

Music (genre, listen, play, produce):

Play musical instruments:

Outdoor Activities (hiking, camping, etc.):

Computers (programming, hacking, etc.):

Games (board, video, etc.):

Literary Arts (reading):

Social:

Other:

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+

A conversation starter for me would be... *

Matching Preferences Grid *

1 -

2 -

3 -

4 -

5 -

Please rate the level of relationship are you seeking, 1 being Academic/Professional, 10 being Personal/Social *

What do you hope to gain by participating in MAP? *

Is there anything else we should know about you that would help us make the best match? (i.e: first generation college student, sexual orientation, etc) *

Do you have the time (6-8 hours per semester minimally) to commit to MAP? *

Password _{must be between
8 and 20 characters}

Password Confirm

Mentor Advocate Partnership Program
Participation Agreement

The Massachusetts Institute of Technology Office of Minority Education (OME) appreciates your willingness to participate in the Mentor Advocate Partnership Program (MAP). 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 MAP Program participants are expected to read, adhere to and sign below acknowledging their commitment to fulfilling program expectations. By participating in MAP, 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 MAP 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 MAP program expectations listed above for the 2024-2025 session

MAP - 2024-2025 SESSION

Protégé Application Form

CONTACT

INFORMATION

Hobbies and Interests

Mentoring agreement

Mentor Advocate Partnership Program
Participation Agreement

MAP - 2024-2025 SESSION

Protégé Application Form

CONTACT

INFORMATION

Hobbies and Interests

Mentoring agreement

Mentor Advocate Partnership ProgramParticipation Agreement

Mentor Advocate Partnership Program
Participation Agreement