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* 1. Name

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* 2. Email

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* 3. Cell Phone Number

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* 4. Cumulative GPA

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* 5. Shirt Size

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* 6. Anticipated Graduation Year

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* 7. RUID #

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* 8. Net ID

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* 9. Major and Minor

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* 10. What campus do you live on?

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* 11. Are you on any kind of Student Conduct Probation?

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* 12. Can you attend the following meetings for training?
- Wed Nov 28th 6:30-9:30 pm on College Ave
- Wed Dec 12th: 6-8:30 pm on Livingston
- Fri Jan 25th: 3:15-7:15 pm on College Ave
- Wed Jan 30th: 6-10 pm on College Ave
- And the following Fridays in the Spring Semester from 3-5 pm on CA:
2/1
2/8
2/15
3/1
3/8
3/29
4/12
4/19
*Please hold these dates*

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* 13. Which PLM interview dates are you available for? Select all that apply

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* 14. Are you involved with anything else on campus? If so, do you hold a leadership position in that organization? How will you make time to be a part of the Peer Leadership Mentor program?

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* 15. If your friends were to describe you, how do you want them to describe you?

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* 16. What is the best advice you‘ve been given? When did you receive this advice and why is it important

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* 17. If you could create a program to engage first year students, with a budget of $100, describe a program you would design and how it relates to leadership.

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* 18. If you’re chosen as a PLM, in 2-3 phrases max, what messages would you want to relay to your first year students?

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