PEER LEADER ACADEMY 2012 APPLICATION FORM

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Contact Information




Getting to Know You

These questions are not required, but may help us match you with someone from a similar background if that is important to you. Please indicate which questions are of particular importance in a mentor.





Understanding Your Academic Interests

Please try to answer as many of the following questions as you can, as accurately as possible. This will help us to match you with someone whose career interests align with yours.



Understanding Your Career Interests





Understanding Your Experience

Please try to answer as many of the following questions as you can, as accurately as possible. This will help us to match you with someone who has the experience you are seeking in a mentor.





Understanding Your Goals






Pledge of Understanding

We try our best to match you with a mentor in a field that you are interested in, but we are not able to guarantee that your assigned mentor fits all your requirements. We also may not have enough mentors in a specific field and cannot guarantee that a perfect match is available for all students participating in the program or that all students will be matched with a mentor. Please answer the following honestly, understanding that while it is OK to say No, doing so may limit our ability to provide you with a mentor.


Just for Fun

The following questions are just for fun. None are required, but your answers will help us match you with mentors who have a similar approach to life.







Thank You!

Thank you for taking the time to fill out this questionnaire. We look forward to meeting you this Spring!

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