New Peer Mentor Application

Application form for New Peer Mentors

Personal Information

Name: *

Last, First, Middle

UNH ID: *

Please include the last four-digits of your UNH Student Identification number, NOT your Social Security number.

Are you applying for a Senior Staff Position?: *

(Juniors and Seniors only)

Cell Phone: *

###-###-####

UNH Email: *

Permanent Address: Street: *

City: *

State: *

ZIP: *

Educational Information

High School: *

College: *

Major: *

Minor: *

Fall 2012 GPA: *

What is your cumulative grade point average: *

Do you have work-study?: *

Have you worked on campus before?: *

Year in school this fall: *

Expected Date of Graduation: *

List the fall campus activities: *

Please list the various campus activities you will be involved fall semester.

Are you going abroad in the 2012-13 academic year?: *

Yes

If you answered yes, which semester will you go abroad?:

Fall

Spring

UNH Faculty/Staff Reference

Acceptable references include: professor, academic advisor, resident assistant, hall director, peer mentor, or UNH faculty and staff. If you are unsure, please contact Stephanie.Bramlett@unh.edu.

Name: *

Phone Number: *

Email Address: *

Employer Reference

Employer reference should be from within the last two years. If you have not been employed previously, you may opt to include a character reference or another UNH faculty/staff reference.

Name: *

Phone Number: *

Email Address: *

Character Reference

The character reference cannot be from a family member or friends. Acceptable references include: academic advisor, resident assistant, hall director, peer mentor, supervisors, community service supervisor, high school guidance counselor/teacher or UNH faculty and staff. If you are unsure, please contact Stephanie.Bramlett@unh.edu.

Name: *

Phone Number: *

Email Address: *

Essay Questions

Please answer the essay questions in complete sentences, 500 words or less. We recommend that you type them in a Word document, spell check, then copy/paste into the application, as it cannot be retrieved after submission.

Why do you want to be a Connect Peer Mentor?: *

In what ways can you serve as an academic role model?: *

What is one important thing you have learned in college?: *

How has participating in the Connect Program had a positive impact on you?: *

Other Information

Biography: *

Upload Picture: *

Upload a picture of yourself.

CONNECT Program

New Peer Mentor Application

Mentor Application