Students Mentoring Students: Mentor Application 1

Students Mentoring Students Program

Mentor Application
Thank you for your interest in the mentor position for this program. We ask that you
please print out this form and fill it out in order to be considered for the mentor position. After
filling this form out please scan it onto your computer and email it to:
studentsmentoringstudents@yahoo.com
If you have any questions feel free to contact us on our website through our contact page.

Personal Information:

First Name: ______________________________ Last Name: __________________________

Phone #: ________________________________ DOB: ________________________________

Gender: ________________ Year in College: ________________ Major: ________________

Address: ______________________________________________________________________

Email Address: _________________________________________________________________

Please Answer the Questions Below:

1. How did you hear about this program?

2. Have you been in any similar programs? If so, please explain.

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3. What are some of your interests?

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 Students Mentoring Students: Mentor Application 2

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4. What do you hope to get out of being in this program?

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5. What do you feel you can add to this program?

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6. Additional Comments:

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Students Mentoring Students: Mentor Application 3