School of Architecture Mentor Program
Mentor Application Fax Form



Date


To

University of Southern California
School of Architecture
ATTN: Academic Advisement
Watt Hall 204, Los Angeles, CA 90089
Tel: 213.740.2090

FAX Number: 213.740.8884

From

Name
Mailing Address


Home Phone #
Business Phone #
Email Address

In which area of architecture do you specialize?


Year of Graduation


Home Town


Graduate degrees from USC/Other Institutions


Special Interests/Hobbies


Any particular requests about the student (e.g. ethnicity, gender, career, life experience, home town)?


Will you be willing to take more than one student (Yes/No)?


If you know the name and address or phone number of others who may be interested in becoming a mentor, please indicate here