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Student Profile for Preceptor Program

The Preceptor Program is designed as a voluntary peer support program for students entering SJC. Preceptors facilitate the development of students entering the nursing profession through student guidance. Incoming students will be mentored by senior students. 

In order to match incoming students with the best possible mentor, please complete the profile below. If you choose not to participate, please indicate by signing at the bottom of this form. 

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* 1. Name

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* 2. Do you live in:

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* 3. If not Springfield, what town do you live in?

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* 4. Which program will you be in?

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* 5. Are you a first generation college student (The first in your family to attend college - neither parent attended college).

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* 6. Do you plan to work while in school?

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* 7. Living Independently?

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* 8. Are you married?

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* 9. Do you have any children?

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* 10. How do you study? 

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* 11. What is your go-to study snack?

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* 12. Fun fact about you:

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* 13. Hobbies/Interests:

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* 14. Professional goals in nursing:

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* 15. If you know a current SJC student with whom you would like to be paired, please list their name

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* 16. I understand this information will be used to match me with a senior student who has similar information and can assist me as I transition to nursing school. Would you like to participate in the Preceptor Program?

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