1. Full name:

2. Title:

3. Organization:

4. Career field specialization:

5. Years of Experience:

6. Mailing Address:

7. E-mail:

8. Day phone and others if applicable:

9. Do you desire a student mentee in your same field?
yes    no

If you have any questions about the program, please contact Aaron Hines, the Coordinator of MBA Program and Special Projects, by phone at (845) 257-2968 or via e-mail at mba@newpaltz.edu.

Thank you for your interest in the MBA/Business Executive Mentor Program!