Fillable PEER MENTOR APPLICATION Thank you for your interest (Howard College)

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PEER MENTOR APPLICATION Thank you for your interest (Howard College)

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PEER MENTOR APPLICATION
Thank you for your interest in becoming a Peer Mentor at Howard College. You may have the opportunity and
privilege to encourage, engage and support students as they begin their educational journey. All applicants
must have an endorsement from their LEADS Coach.
PERSONAL DATA – PLEASE PRINT
Student ID #:
Last Name First Name Middle Initial
Position Interest: □ New Peer Mentor □ Returning Mentor
Semester: 2019-2020
Phone Number:
Email:
Best Contact? □ PHONE □ EMAIL
Highest Degree Attained:
Current Location: □ Big Spring □ Lamesa
□ San Angelo □ SWCID
Program of Study:
Earned Credit Hours:
Area(s) of Interest:
□ Health Sciences □ Business/Industry □ Arts/Humanities □ STEM □ Public Service □Undecided
If selected, Peer Mentor must participate in all training activities and meetings. Including those required
outside of the regular academic schedule. Peer Mentor must have satisfactory attendance.
Have you read the description of the position you are applying for? □ YES □ NO
ESSAY QUESTIONS – USE SUPPLEMENTAL SHEETS IF NEEDED.
Please provide a brief summary of your experience in the HC LEADS program.
Please explain your interest in being a Peer Mentor in the HC Leads program.
In your own words, define the role of a Peer Mentor.
Describe your greatest strength(s) applicable to being a Peer Mentor.
List any anticipated activities/employment for the work semester identified on page 1.
List any activities you are currently involved in or have been in the past at Howard College/SWCID.
Please list any specialized training or certificates.
HC LEADS COACH ENDORSEMENT
AS SUPERVISOR OF THIS APPLICANT, I SUPPORT HIS/HER QUEST TO SERVE AS A COACH/MENTOR.
________________________________________________
HC LEADS Coach Printed Name
________________________________________________ _______________________
HC LEADS Coach Signature Date
AGREEMENT
I CERTIFY THAT ALL OF THE INFORMATION IN THIS APPLICATION IS TRUE AND CORRECT. IF SELECTED FOR
THE ROLE OF PEER MENTOR, I AGREE TO COMPLETE ALL MANDATORY TRAINING BEFORE STARTING THE
POSITION.
________________________________________________ _______________________
Applicant Signature Date
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PEER MENTOR APPLICATION Thank you for your interest (Howard College)

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Completed 4 February 2021

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