PIER Program
Promoting Independence and Educational Resources
Mentee Application Form
Overview of PIER
The Promoting Independence and Educational Resources (PIER) program is a one-semester, voluntary
transition and retention program targeting freshmen and new transfer students with disabilities enrolled in
Disability Resource Programs (DRP) at California State University Channel Islands (CI). The PIER program
connects first-year freshmen and transfer students to knowledgeable peer and staff mentors who help them
get academically and socially acclimated to CI. The PIER program will encourage students to interact with
campus resources and develop academic skills needed to be successful.
Requirements include: weekly meetings with a mentor, attending one workshop offered during the
semester, and meeting with an academic advisor and instructors at least once during the semester.
Purpose
The purpose of the PIER program is to provide first-time freshmen and new transfer students a smooth transition
to CI and collaborative assistance in order to highlight strengths, promote independence, support academic
success, and empower students to reach their full potential. DRP wants to ensure that incoming students feel
connected and supported by peer mentors who are available to share their knowledge and experience as
college students of CI. Mentors focus on welcoming, supporting, and encouraging incoming students as they
navigate a new university. Mentors aim to provide students information about campus resources including
tutoring, counseling, advising, health services, and library services. Mentors are also available to help students
develop effective learning strategies including study skills, organization, time management, and self-
advocacy.
Applicant Information
*Please note: This application should be completed by the student applying to the program.
Semester: Fall / Spring
Full Name:
Last First M.I.
CI Email Address:
Major/Minor:
Major Minor
Student ID: Phone Number:
Class Standing: Freshman Sophomore Junior Senior
Share your responses to the following questions
How did you hear about this program?
DRP Staff Member
DRP Student Assistant
Flyer
Website
Other
What goals do you have for the upcoming semester at CI?
What ar
e some of your strengths, abilities, natural talents?
What are three challenges you may face as a student at CI?
What particular skills would you like to strengthen or improve this semester at CI?
What do you hope to gain by participating in the PIER Program?
Days/Hours of Availability
Example: Monday 9:00A a.m.o 12:00 p.m.
(This indicates availability on Mondays from 9:00 a.m. to 12:00 p.m.
)
*This information will help DRP determine a day and time for weekly meetings with your assigned mentor.
Monday:
Tuesday
Wednesday
Thursday
Friday
Student Signature Date
Counselor Signature Date
Next Steps
1. Please complete and return this application to the Educational Access Center (Bell Tower 1541) or by email
to: pierdrp@csuci.edu.
2. Upon submitting this paperwork, please allow up to 10 days for processing and review.
3. Once your application has been reviewed, you will be contacted by a DRP counselor.
4. Please note: Availability in the PIER program is limited, and applications will be reviewed on a first-come, first-
served basis.
5. If there is no availability, you will be contacted and your name will be placed on a waitlist.
6. For any questions or concerns please call the Educational Access Center at (805) 437-3331.