Science Alliance Mentor Application 2018-19
Thank you for applying to be a Science Alliance Mentor for the 2018-2019 school year. Being a Science Alliance member requires commitments which include:
-Mentor trainings once a month during lunch
-Mentor-Buddy meetings once a month after school on Mondays
-Attendance at the Science Fair on April 13, 2019

Please carefully follow the instructions below with regard to your application:

1. Application deadline has been extended to October 23(Tuesday).
2. After filling out the application, and BEFORE YOU SUBMIT IT, please print out the first page of this application. Turn this page in to Room 901 by October 23, so that we have a physical record of your application.
3. Read the directions at the bottom of the application with regard staff recommendation.

Please direct all questions to

First Name: *
Your answer
Last Name: *
Your answer
Cell Phone Number: *
Format: (xxx) xxx-xxxx. If you do not have a cell phone number, please provide your home phone number.
Your answer
Email Address: *
Your answer
Confirm Email Address: *
Please retype your email address to ensure that it is accurate.
Your answer
T-Shirt Size: *
All sizes are ADULT. If for some reason none of these sizes work, please let us know at the bottom of this form.
Grade Level: *
Current Science Classes(es)/Teacher(s) *
Example: Honors Anatomy & Physiology/Bandrowski, Honors Physics/Getty
Your answer
Optional: Special Buddy
If you are selected as a mentor and there is a certain 5th grade student who is a neighbor/sibling/etc. you would like to be paired with, then please provide us with the name and school of that student. We will do our best to accommodate that request.
Your answer
Past Science & Math Classes *
Please list ALL past high school science and math classes you have taken and the grades you received for each semester. Format: (Class/Teacher- Semester 1 Grade/Semester 2 Grade). For Example, Honors Anatomy & Physiology/Bandrowski- A/A, Honors Physics/Getty- A/B
Your answer
Returning Mentor? *
Have you been a Science Alliance Mentor before?
Year(s) of Previous Mentoring
If you answered yes to the above question, what year(s) were you a mentor in Science Alliance? If you have not been a Science Alliance mentor before, skip this question.
Field of Expertise *
What scientific fields are you most knowledgeable in and comfortable assisting students with? (ex: Biology, Chemistry, Physics, etc.)
Your answer
Reason for Mentoring *
Why do you want to be a mentor for Science Alliance?
Your answer
Science Qualification *
Why do you think you are qualified to assist students in a science fair project?
Your answer
Mentoring Abilities *
Why do you think you are qualified to work with 5th graders? What are some past experiences that illustrate your abilities as a mentor/role model?
Your answer
Buddy Preferences *
We want to ensure that you and your buddy are a good match, so please help us do so by indicating any preferences you might have. (ex. - if you are a quiet person and would like a quiet buddy, etc.) Although we cannot make any guarantees, the more information you give us (along with the information we receive about the buddies), the better the pairings we will be able to put together.
Your answer
Use this space if you had any issues with this application or you have questions or comments for the Science Alliance team. If not, just leave this space blank.
Your answer
Stop Here and Print Out Your Application
You only need to print out the first page. After printing the first page of your application, continue on and follow the remaining directions.
Please Read and Complete the Following Directions before Submitting
1. Turn in these the first page of the application to Mr Jensen, room 901. There is a box by the door that says Science Alliance.

2. Print out a teacher recommendation form at the link below and give it to one of your teachers to complete (preferably a science or math teacher).

3. Press the "Submit" button at the bottom of this page.

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