1. THE NETWORK Peer Mentor Program - Application

PROGRAM AND SERVICES

The NETWORK Peer Mentor Program provides academic support, leadership and professional development, social activities and referral services,

Apply today if you are interested in achieving success in college, meeting new people, and having fun!

* Please note that the NETWORK Peer Mentor program has 40 available openings in this year's program. If you are accepted in the program you will be notified directly by e-mail and/or phone.

Is this your first semester of College at Tompkins Cortland CC?

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* 1. Is this your first semester of College at Tompkins Cortland CC?

Are you filling this survey out after September 2nd?

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* 2. Are you filling this survey out after September 2nd?

APPLICANT INFORMATION

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* 3. APPLICANT INFORMATION

Gender

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* 4. Gender

What is the highest degree obtained by a parent(s)/Guardian(s) in your household?

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* 5. What is the highest degree obtained by a parent(s)/Guardian(s) in your household?

Ethnicity:

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* 6. Ethnicity:

Degree Program at Tompkins Cortland CC

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* 7. Degree Program at Tompkins Cortland CC

What are your professional goals? (Please write "undecided" if you are undecided, or you may wish to list a few possible areas of career interest)

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* 8. What are your professional goals? (Please write "undecided" if you are undecided, or you may wish to list a few possible areas of career interest)

What is your primary motivation for joining the Network Peer Mentor Program?

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* 9. What is your primary motivation for joining the Network Peer Mentor Program?

Describe yourself in three words

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* 10. Describe yourself in three words

Please describe in detail why you would like to participate in the Network Peer Mentor Program.

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* 11. Please describe in detail why you would like to participate in the Network Peer Mentor Program.

PLEASE SELECT LEVEL OF INTEREST FROM THE LIST BELOW

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* 12. PLEASE SELECT LEVEL OF INTEREST FROM THE LIST BELOW

  Not Interested Somewhat Interested Very Interested
Music
Art
New Media
Writing/Poetry
Meeting New People
Spirituality
Social Networking
Cooking
Politics
Adventure/Outdoors
Four Year College
Leadership Opportunities
Study Abroad

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