2016 University Honors Peer Mentor Application

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

First Name

Last Name

Email Address

Major (Primary Major)

Please be as specific as possible (Mechanical Engineering rather than Engineering or Accounting vs. Business)

Major (Secondary Major or N/A if you only have 1 major)

Please be as specific as possible (Mechanical Engineering rather than Engineering or Accounting vs. Business)Untitled Title

Minor(s)

Specialty Programs (e.g., Quest, Federal Semester, Global Semester, etc.)

Career Interests (perfectly ok to be undecided but if you know what you'd like to do professionally, I can more effectively match you with a new student)

Would you like to mentor individually or as part of a team?

Individual (1-3 students)

Individual (3-5 students)

Team (5-7 students)

Clear selection

Who would you like to team mentor with? (Please provide first and last name for your partner. He/She will also need to complete the application.)

Please provide an email address for the person you'd like team-mentor with?

Do you have at least a 3.0 GPA?

Yes

No, but I'm getting there. (If you don't have a 3.0 - yet. I'd like to have a conversation and learn more about your cirucumstances)

Clear selection

Did you participate in the Peer Mentor Program last fall?

Yes - I had a mentor

Yes - I was a mentor

No - I'm brand new to the program

Clear selection

Are you in University Honors?

Yes

No- completely ok to participate if you are in a different HC program but all first-year students will be University Honors. Please see your program staff if you'd like to mentor students in your program.

Clear selection

The Peer Mentor Program is a stepping stone to becoming an HONR100 Section Leader. Would you like to be considered for that program?

Yes

No - I prefer to just mentor students

Maybe - I need to give it some thought

Clear selection

As part of the program, there is an optional 1-credit Peer Mentor course designed to support mentors as they work with students. Course focus is on coaching and teaching mentoring, motivation, and time management strategies. Would you be interested in this course?

Thursdays from 11-11:50 a.m.

Thursdays, 4:00-4:50

No, thanks. I have a conflict and will not be able to take the class.

Clear selection

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms