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PASA Mentoring Program Application 2012 – 2013

The PASA Mentoring program aims to build community by fostering relationships between new and continuing students in the PASA program. Once matched, mentors and mentees may determine the bounds of their relationship, but all program participants are expected to:  Communicate (in-person, email, phone, etc.) at least once every two weeks for the entire academic year  Check-in with the Mentoring Coordinator once each semester  Attend PASA Mentoring Events  Participate in the PASA End of Year Banquet Please fill out the application below if you are interested in participating in the PASA Mentoring Program. I am applying to be a: Mentor Mentee

Name: ______________________________________________________ Year: [ ] 1st [ ] 2nd [ ] 3rd

Are you a non-traditional student? Y N Gender: ___________________ Local Address: ________________________________________________________ Local Phone: ___________________ Email: _______________________________ Educational background (degrees earned): Current employment (if any) and brief work history:

Future professional goals:

Please return completed applications by Friday, September 7th. Thank you!

Functional areas of interest (ex: Orientation, Academic Advising, etc.): Hobbies:

In order of importance, please list 5 characteristics or attributes you would like in your Mentor or Mentee (ex: shared professional goals, experience in a specific functional area, commuter status, etc.):

What do you hope to gain from the PASA Mentoring Program? Is there anything else you would like to tell the Committee who will match the Mentors and the Mentee?

Please return completed applications by Friday, September 7th. Thank you!