M.A.L.E.S. Men Achieving Leadership, Excellence and Success

Email Address @northshore.edu*NSCC email addres

Personal Email address*

Current age*What is your age when you join the M.A.L.E.S. organization

Did you earn a high school diploma or a GED/HiSet?

High School Diploma

GED HiSet

Other

What year are you in at school?*

What school are you attendoing?*

What did you like best about high school? Also, what subjects did you enjoy most?*

What challenges did you face while in high school? Also, what subjects did you like least?*

How did you hear about M.A.L.E.S.?*

How can M.A.L.E.S. best support your academic and personal success? Please select the top 3 services that you think you will access the most.*

Ethnicity: Hispanic/Latino

Yes

What is your primary language?*

Do you plan to attend:

Full time (12 or more credits)

Part-time (11 or less credits)

Have you ever attended college before?*

What is your major/program of study?*

Which campus/campuses are your classes?*

If you plan on transferring to a four year college, do you plan on transferring before or after you graduate from NSCC?

I plan on transferring AFTER I earn my degree from NSCC.

I plan on transferring BEFORE I earn my degree from NSCC.

I do not plan on transferring.

Not sure.

Other

Are you a student veteran?

Yes

Have you applied to the TRIO Program?

Yes

Please describe your career goals?*

During the FIRST THREE WEEKS of your FIRST SEMESTER at NSCC, about how many hours do you expect to spend in a typical 7-day weekPreparing for class (in a typical 7-day week)?

None

1-5 hours

6-10 hours

11-20 hours

21-30 hours

More than 30 hours

During the FIRST THREE WEEKS of your FIRST SEMESTER at NSCC, about how many hours do you expect to spend in a typical 7-day week Working for pay (in a typical 7-day week)?

None

1-5 hours

6-10 hours

11-20 hours

21-30 hours

More than 30 hours

What is your job title?*

Who is your employer?*

Please describe any of your leadership, teamwork, community service or volunteer experience. If you have no experience, please write N/A.*

How would you describe your computer literacy skills?

Good

Fair

Poor

List your hobbies and interests.*

What are your strengths?*

What are your weaknesses?*

How would your friends describe you?*

I am confident in using My Northshore

1 Strongly Disagree

5 Strongly Agree

I am confident in using Blackboard

1 Strongly Disagree

5 Strongly Agree

I know my student ID# or have it stored safely

Yes

Emergency Contact Name*

Emergency Contact Phone*

Relationship to You*

In 50 words or less, tell us what you hope to gain as a member of M.A.L.E.S.?*

M.A.L.E.S.

Sign up for the M.A.L.E.S. Organization

Ready to Begin?