Office of Multicultural Development - Peer Mentor Application
First Name: *
Last Name: *
Student ID: *
I am a:
Returning Peer Mentor
Date of Birth: *
American Indian/Native Alaskan
Native Hawaiian/Pacific Islander
I prefer not to answer
Local Campus Address:
Cell Phone: *
Personal Email: *
Summer/Permanent Home Address: *
Zip Code: *
I am a: *
I am a student in:
Number of academic credit hours completed to date: *
How many academic credits do you expect to enroll in during fall 2015? *
I will be employed
campus, on a
basis during the 2016-2017 academic year, anticipating working
hours a week. *
Current Cumulative Grade Point Average (GPA): *
Only students with a verified CUM GPA of 2.75 or higher will be considered for this position.
Have you ever been on academic probation or suspension? *
If yes, please explain the circumstances prompting your probation or suspension.
List any and all University of Akron co-curricular activities you have been involved with, briefly describing your experience.
I have used the following student services or resources on campus (please check all that apply):
Office of Multicultural Development
Counseling, Testing & Career Center
Student Financial Aid
Office of Accessibility
Academic Advisement Center or Summit Advising
Residence Life & Housing
Associated Student Government
Supporting Information About You
1. As a student, have you ever been mentored by a Peer Mentor? *
2. How/Where did you learn about the possibility of becoming a Peer Mentor?
3. What sparked your interest in becoming a Peer Mentor in the Office of Multicultural Development? Please explain your answer.
4. How do you foresee Peer Mentoring contributing to your own personal, professional, and academic development?
5. What would you bring to the program that would contribute to the development of your fellow mentors and the mentees you would work with?
6. What would you attribute your success at The University of Akron to?
7. What is the greatest challenge facing UA’s multicultural students (e.g., students of color, adult students, international students, etc.)? Identify and explain.
8. Please write the one piece of advice you wish someone had given you the day before you started your college career.
9. Please discuss your career goals both while and after completing your degree.
The above information is correct to the best of my knowledge. By submitting this form I also give the Office of Multicultural Development permission to verify this information as well as information regarding my academic and disciplinary status. I understand that the falsification of this application form in any way is ground for disqualification from further consideration for the position of Peer Mentor.
An asterisk (*) denotes a required field
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