Engineering Residential College Peer Mentor Application
Please fill out the following application and submit, along with your written statement, resume, and recommendation letter to
Brickyard 697. The deadline to apply is Dec. 12, 2012 at noon. Late applications will not be accepted. You will be contacted in
January, 2013 via e-mail if you are selected for an interview.
Applicant Information
Name
Gender
ASU Affiliate ID#
Cumulative GPA
(If this your first semester at ASU, please leave this blank.)
Major
Academic Standing Fall 2013: Soph.
Are you a part of Barrett, the Honors College?
Y
City
Preferred Phone #
Preferred Email Address
Summer Address
City
Y
N
Y
State
Zip
______
State
Zip
If yes, where?
If not currently a freshman, did you live on campus as a freshman? Y
Did you attend E2 Camp as a freshman?
Senior
N
Current Address
Do you currently live on campus?
Junior
N
If yes, where?
N
Did you apply for a Community Assistant (CA) or Sun Devil REP position for 2013-14?
Y
N
What extracurricular activities and/or employment (on or off campus) do you have for the 2013-2014 academic year?
*Please note, that being involved in extracurricular activities and/or employed in any additional position on or off campus more
than eight hours per week is not permitted for this position. Working and/or being involved in extracurricular activities more than
eight hours per week will result in removal from the Peer Mentor position.
T-Shirt size: S M L XL 2XL
Polo Shirt Size: S M L XL 2XL
I acknowledge that the information in this application is factual and is a realistic assessment of my abilities. Because I recognize
that being a Peer Mentor carries with it both privileges and responsibilities, I hereby give permission to the Ira A. Fulton Schools
of Engineering and the Coordinator Senior, First Year Programs to obtain information regarding my ASU academic and
disciplinary records. I understand that this consent applies to educational records that may otherwise be protected under the
Family Educational Rights and Privacy Act of 1974, as amended, U.S.C. 1232g. This information will be used for the sole
purpose of determining my personal attributes and suitability for this position.
____________________________________
__________________
Signature
Date
Written Statement
Attach a one-page statement expressing why you are interested in being an Engineering Residential College Peer Mentor. Discuss
your involvement in the Ira A. Fulton Schools of Engineering, what you think a Peer Mentor does, your leadership qualities, and
any skills or experiences that relate to this position.
Resume
Please include an up-to-date version of your resume with your application. Your resume should include your work
experience/employment history, extra-curricular activities, community service participation, leadership positions held, etc.
If you are not familiar with how to write a professional resume, please visit the Engineering Career Center.
Recommendation Forms
All applicants must submit one recommendation letter. Recommendations should be from a person who can assess your skills
and abilities and can comment on your potential as an Engineering Residential College Peer Mentor.
Recommendations should be completed by an ASU faculty or staff member. This could include a teacher, academic advisor,
community/assistant community director, or student organization advisor (current peer mentors and community assistants are not
acceptable).
Please ask the individual completing your recommendation letter to return it to you in a sealed envelope so you may turn it in with
your application. Letters can also be sent directly to Becca Kleinberg, Coordinator Senior, First Year Programs.
On-campus mailing address: MC 8109
Off-campus mailing address: P.O. Box 878109, Tempe, AZ 85287-8109
Fax: 480-965-8095
Email: beccapk@asu.edu
Recommendations must be turned in by the application deadline or your file will be considered incomplete.
Selection Timeline
Application Review Period: December 13, 2012 – January 4, 2013
Invitations for interviews sent via email: January 8, 2013
Interviews held: February 1 – 15, 2013
Notification of application status via email: February 22, 2013
Deadline to accept or decline position: March 1, 2013