Towson University
Center for Student Diversity - SAGE Program
Peer Mentor Application – Reference Form
Applicant’s Name: ________________________________________________________________________________________
Personal Reference Information:
Name: __________________________________ Position/Organization: _____________________________________________
Email Address: __________________________________________ City: ___________________ Zip Code: _________________
Personal Reference: The individual listed above has applied for a SAGE Program peer mentor position with the Center for Student
Diversity at Towson University. SAGE Program mentors interact with freshmen from diverse backgrounds. Their responsibilities
include: befriending freshmen, encouraging academic achievement, facilitating networking and involvement on campus, and
collaborating with peer mentors to plan program activities. Applicants should possess a. strong interpersonal skills, b. ability to work
as a team member with individuals from diverse backgrounds, c. knowledge of campus resources and student organizations, d. some
experience serving others, and e. good academic credentials.
How long have you known the applicant and in what capacity? _______________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Please rate the applicant in the following areas:
Excellent
Above
Average
Average
Below
Average
Unable to
Respond
Academic Ability
Integrity
Dependability
Community Service
Communication Skills
Initiative
Problem Solving Skills
Maturity
Appreciation of Diverse Cultures
Leadership Skills
Time Management
Please use the space below to provide additional information (attach an additional sheet if necessary).
Please check the appropriate statement below:
Highly Recommend
Recommend with Reservations
Do Not Recommend
Questions can be directed to Tammie King-Kelly via email (tkingkelly@towson.edu) or by calling 410-704-2051. Please email this
completed form to Tammie King-Kelly.