North Star STEM Alliance UMM Peer Mentor Application
How This Information Will Be Used:  The information you submit on this form will be used by college/university officials and other Alliance administrators to evaluate your eligibility to become a North Star participant and report data to the National Science Foundation (NSF) for that office to evaluate program effectiveness.  The NSF requires the collection of this information as a condition of program funding.  

As a North Star participant, information about your participation in program events will also be provided to the NSF at the end of the year, which is a prerequisite for you to be eligible for a stipend.  If you are eligible for a stipend for your participation in the program, you will be required to submit your SSN, which will be provided to the NSF and tax officials on order to process the payment.  Please contact Joe Alia at aliaj@morris.umn.edu if you have questions about the application process or information handling.

Access of academic information:  Please be assured that the academic information gathered will be aggregated.  Thus, only system-wide and campus-wide reports will be produced.  No individual data will be reported.
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First Name *
Last Name *
Student ID
Morris Email
Telephone Number
Major(s)
Please list all declared majors
Minor(s)
Please list all declared minors
Enrollment Status
Class
Gender
Ethnicity
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Race
Check all that apply
Disability Status
Are you receiving financial support in the 14-15 academic year?
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