St. Cloud Technical and Community College is accredited by the Higher Learning Commission of the North Central Association of Colleges and Schools.
St. Cloud Technical and Community College is a member of the Minnesota State Colleges and Universities system.
ADA Accessible Facility • Affirmation Action/Equal Opportunity Educator and Employer.
Academic Advising Center
Academic Peer Mentor
Application Packet
To!be!considered!for!a!position!as!an!Academic!Peer!Mentor,!
complete!the!following!items:!
r Application
r Scheduling form
r Online reference form, completed by faculty or staff
member - Separate form to download
Return'completed'packet'to'Room'1-312'by'
4'pm'on'Thursday,'October'26
th
,'2017'''
!!
'
!Please!print!legibly!in!blue!or!black!ink!or!type!out!and!print!or!email.!!
'
First!Name:!__________________________!Last!Name:!__________________________!Tech!ID:!____ _ _ _ _ _ _ __ _ _ _ _ _ _!
Preferred!Name:!____________________________________________________________________________________!
SCTCC!Email!Address:!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!@my.sctcc.edu! Phone!Number:!________________________________!!
Major:!_____________________________________________!!!!Expected!Graduation!Date:!_______________________ !
Do!you!meet!the!following!requirements?!
I!have!a!c u mulative!G P A !o f!2 .5 !o r !h igh e r .!
□!Yes!
□!No!
□!Unsure!
I!have!co mpleted !at !lea s t!o n e !se mester!at!SCTCC.!
□!Yes!
□!No!
□!Unsure!
Briefly!explain!why!you!are!interested!in!becoming!a!Peer!Mentor.!
__________________________________________________________________________________________________!
__________________________________________________________________________________________________!
__________________________________________________________________________________________________!
Please!list!previous!work,!experience,!and/or!skills!and!how!they!would!benefit!you!in!the!role!of!Peer!Mentor.!
__________________________________________________________________________________________________!
__________________________________________________________________________________________________!
__________________________________________________________________________________________________!
Attach!additiona l!pag es!a s!ne cess ary .!
! !
Scheduling Form
*List!any!courses,!meetings,!work,!or!other!commitments!you!may!have!during!spring!semester!AND!summer!2017*
LIST:'Course/work/etc.'
DAY'
BEGIN'DATE'
END'DATE'
Will!you!be!attending!SCTCC!in!Spring!2018?!!r!Yes!!r!No!!r!!Unsure!at!this!time!
Please'initial:__________'I'certify'that'the'above'statements'are'true'to'the'best'of'my'current'knowledge.'I'
will'make'the'Academic'Advising'Center'aware'of'any'additional'requests'for'time'off'immediately.'
Click here to submit your
Application and Scheduling
form via email
You may also print this form and deliver to Academic Advising in Northway 1-312