CSSP Mentor Application for Spring 2010 Survey

If you need more information while completing the application please visit www.penncssp.com. The purpose of this application is to review your reasons for community involvement based on the questions at the bottom, and to appropriately place you in one of our programs based on your interest and availability.

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1. Basic Information

Basic Information Full Name
Email Address
Phone Number

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2. Classification

	Class	School	type of Position
Classification	Classification Classification Class	School	type of Position

If you are a Graduate Student, please specify which school

3. CSSP offers multiple forms of student involvement within schools.
-If you know which segment(s) of programming you want to join, please select below.
-If you are flexible in your preference, please skip to the next question and we will place you based on your availability.
Please find program descriptions here www.penncssp.com

CSSP offers multiple forms of student involvement within schools. -If you know which segment(s) of programming you want to join, please select below. -If you are flexible in your preference, please skip to the next question and we will place you based on your availability. Please find program descriptions here www.penncssp.com K-8 After School Programs

Penn Reading Initiative (PRI) School Day Literacy Tutoring

K-8 School Day Tutoring

High School School Day Tutoring

High School After School

Recess Initiative (K-8)

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4. Please select the days and times you are available and willing to work with our programs. Volunteers are required to work one day per week, Work-study students are required to work at least two days per week. Transportation to and from the schools is provided. (note: the hours category reflects the range of available hours in each program, not the required hours)

	Days of the Week	Available Hours	Program Preference
First Available Day	Please select the days and times you are available and willing to work with our programs. Volunteers are required to work one day per week, Work-study students are required to work at least two days per week. Transportation to and from the schools is provided. (note: the hours category reflects the range of available hours in each program, not the required hours) First Available Day Days of the Week	Available Hours	Program Preference
Second Available Day	Second Available Day Days of the Week	Available Hours	Program Preference
Third Available Day	Third Available Day Days of the Week	Available Hours	Program Preference
Fourth Available Day	Fourth Available Day Days of the Week	Available Hours	Program Preference

If you've chosen School Day Hours, or if you have additional availability, please list the specific times you are available here

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5. Do you have any experience tutoring/mentoring or working with children? If yes, explain your experience. If not, why are you interested in becoming a mentor now?

Do you have any experience tutoring/mentoring or working with children? If yes, explain your experience. If not, why are you interested in becoming a mentor now?

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6. Please describe one personal goal you'd like to achieve while working with our organization.

Please describe one personal goal you'd like to achieve while working with our organization.

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7. Why do you feel it is important for Penn to get involved in the community?

Why do you feel it is important for Penn to get involved in the community?

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8. Are you interested in leading or sharing any enrichment activities with the children in our program (for example: dance, a sport, art, drill team, science fair, or anything else you’re interested in)? If you do have something you'd like to share, describe it below.

Are you interested in leading or sharing any enrichment activities with the children in our program (for example: dance, a sport, art, drill team, science fair, or anything else you’re interested in)? If you do have something you'd like to share, describe it below.

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9. How did you find out about CSSP? (Please check all that apply)

How did you find out about CSSP? (Please check all that apply) Student Activities Fair (Locust Walk)

saw a poster hung in dorm building or classroom building

Student Employment Office or Fair

from someone who is already a member of CSSP

saw an Ad in the Daily Pennsylvanian

from Facebook

from Groups Online at Penn

from the Netter Center website

from the Fox Leadership website

Other (please specify)

10. If you have any additional comments please feel free to add them here.

If you have any additional comments please feel free to add them here.

CSSP Mentor Application for Spring 2010Exit this survey