SUSTAIN: Excellence Mentor Application

First Name *

Middle Initial * If Applicable

Last Name *

Preferred Name * Indicate preferred name for name tags, introductions, etc.

MUID * 9 digits

Current Campus/Local Address * Include street, unit/apartment number (if applicable), city, state and zip code.

Summer Address * Include street, unit/apartment number (if applicable), city, state and zip code.

Email *

Cell/Phone Number * Please include area code (e.g. 123-456-7890)

Preferred Method of Contact *

Current Age *

Birthdate * mm/dd/yyyy

Sex *

If other, please specify *

Are you Hispanic or Latino? *

What is your race? * American Indian or Alaska NativeAsian (including Indian subcontinent and Philippines)Black or African American (including African and Caribbean)Native Hawaiian or Other Pacific IslanderWhite (including Middle Eastern)Prefer not to respond Select one or more

What is your religious affiliation? *

Do you identify as a First Generation Student? (Both parents or legal guardians do not have a Bachelor's Degree) *

Academic College *

Academic Major(s) * If you are undecided, include your intended major.

Class Standing as of Fall 2013 *

Expected Graduation Date *

Are You a Transfer Student? *

Are You a Commuter Student? *

Are You able to commit to the Golden Eagle Institute (GEI) training on Saturday, April 13, 2013 from 9am-4pm? *

Are You able to commit to the Mentor Training Retreat on May 13-14, 2013 (Tentative)? *

Are You able to commit to the Fall Mentor Training on Saturday, August 24 - Sunday, August 25, 2013 (Times TBD)? *

Are You able to participate in activities during New Student Orientation from Wednesday, August 21 - Sunday August 25, 2013?? *

All participants in the SUSTAIN: Excellence Program will be expected to be available Thursday evenings from 5-7pm to participate in training and activities promoting social, leadership and intercultural development. Are you able to commit to meeting on Thursdays between 5-7pm in Fall 2013? *

I understand if I'm accepted into the program and choose to participate as a mentor, I agree to actively participate in all components of the program (i.e. peer mentoring, success series workshops, networking/discussion groups). * I agree

Please respond THOROUGHLY to the questions below in 150 words or less:

What inspired your interest to apply to be a mentor with the SUSTAIN: Excellence program? How will this position enhance your experience as a Marquette student/student leader? *

List current and past leadership experiences, student organizations, campus activities and/or employment you have been involved with while at Marquette. Include years and in what capacity. *

The goals of the SUSTAIN: Excellence program seeks to support the social, intercultural, leadership, and academic development of students of color, students from diverse religious backgrounds, first-generation students and/or students and allies in the LGBTQ community. Given this information, please describe to which community you belong: *

Considering the communities you described belonging to in the previous question, how do you foresee membership in these communities influencing your ability to connect a protégé? *

Describe your experiences as a Marquette student and student leader? How would you support your protégé to navigate similar and/or different campus experiences? *

What additional information would you like to share about yourself that would be important for the coordinators to know when reviewing your application? *

SUSTAIN: Excellence Mentor Application

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SUSTAIN: Excellence