PEER MENTORSHIP PROGRAM
Faculty of Health Sciences
FHS Peer Mentorship Program 2015/2016
PEER MENTOR Position Application
Name _____________________________
Student ID ____________________________
Local Address ______________________
Phone ________________________________
Cell Phone _________________________
SFU Email Address_____________________
Current “Year” Of Study _____________
Gender M / F
Cumulative GPA ________
HSCI Program
BA / BSc
Expected Final Semester (before graduation) __________________________________
First Language ______________________ Second Language ____________________
Will you be available during the Summer for mentor training on Saturday July 26th ? Describe any prebooked summer plans you have.
___________________________________________________________________________________
I can make a two-semester commitment (Fall 2014 & Spring 2015):
 Yes
 No
Have you participated in any SFU Mentorship programs before?
 Yes
If YES, in what capacity and for how many years?
___________________________________________________________________________________
 No
Which SFU campus do you live near/spend the most time at?
 Surrey
 Downtown
 Burnaby
Please answer the following questions as completely as possible.
1) Why would you like to become a Peer Mentor with the FHS Peer Mentorship Program?
PEER MENTORSHIP PROGRAM
Faculty of Health Sciences
2) Please list all previous leadership/volunteer/extracurricular experiences you have had that
recommend you to be a Peer Mentor:
3) Describe three qualities you possess that you believe would be most valuable in helping you
succeed as a Peer Mentor.
4) Describe what “active listening” means to you and how you have applied this concept in
your own communication with friends, family, coworkers, and/or students before.
PEER MENTORSHIP PROGRAM
Faculty of Health Sciences
5) What would you bring to the Peer Mentorship Program? If you have already had some
experience with this mentorship program, please describe what you would want to develop
or improve upon.
6) Future Career Plans:
I have read the job description at fhspeer.weebly.com and to the best of my knowledge the
information on this application is complete and honest.
Name (does not have to be handwritten) __________________________________
Date ______________________
Due Jul 1st, 2015– Attach this application form & a copy of your Resume in an email to
fhspeer@sfu.ca