Please return this form to LHP Program Director Susan Wawrose, wawrose@udayton.edu or
University of Dayton School of Law, 300 College Park, Dayton, Ohio 45469
10/2016
Leadership Honors Program/Mentoring
Request a Change
Use this form to request a new mentor, a different student or, if you are a mentor, to discontinue your
participation in the LHP Mentoring Program.
Your name: _______________________________________________________________
Your email address: ________________________________________________________
Your current mentor/student: _______________________________________________
What are you requesting?
______New mentor ______New student
______Discontinue participation in the Program (mentors only)
Reason for the request (this information will be kept confidential and will only be used to improve the
Mentoring Program):
What characteristics would you like to see in your new mentor/student?
