IMPACT Peer Leaders
integrated mentoring program and core training
APPLICATION INSTRUCTIONS
We invite you to apply to become an IMPACT Peer Leader. Peer leader responsibilities
and requirements are described for various leadership opportunities at the end of this
document.
Mandatory training dates for IMPACT Peer Leaders are listed on page 3. Before
beginning your application review the training dates and be sure that you are able to
attend these trainings.
Complete applications include 5 parts, as outlined below, and are due on April 8th, 2015.
Incomplete or late applications will not be considered.
Part 1 – IMPACT Peer Leader Job Application (page 4 of this packet)
Part 2 –Interest Statement
Submit a one-page interest statement addressing the following questions:
 Why are you interested in becoming an IMPACT Peer Leader?
 What skills (qualifications/experiences) would you contribute as an IMPACT Peer
Leader?
 What do you hope to gain from serving as an IMPACT Peer Leader?
Part 3 –Resume
For assistance in writing your resume, visit the Writing Center or your college’s Career
Services office.
Part 4 –Transcript
You may either print and submit an unofficial transcript OR request the Office of the
Registrar, located at 333 East Campus Mall #10101, send an official transcript.
Part 5 – Recommender Release Form
Complete the Recommender Release Form on page 5 of this packet. All applicants must
have two recommenders, including at least one current UW-Madison employee who is
familiar with your academic or extracurricular work. Appropriate recommenders include:
faculty or staff instructors, academic advisors, research mentors, assistants and student
teaching assistants, program staff, student organization advisors, student work supervisors.
Submit COMPLETE application packets to the below address or email
jwhitmore2@wisc.edu :
WISCIENCE
Room 118 445 Henry Mall
Madison, WI 53706
2|Page
IMPACT Peer Leaders are mentors and role models who possess leadership qualities and
are dedicated to helping fellow UW-Madison students succeed. Peer Leaders help less
experienced students navigate and get connected to the university
PROGRAM POSITIONS
MadBiology Boot Camp Counselors



Provide support for all components of
the Boot Camp program, including
check-in and check-out
Lead small group discussions with
camp participants
Actively engage with the curriculum of
Boot Camp
RESPONSIBILITIES AND DUTIES
Help students become independent learners.
Model good student behavior – take notes, be on time, etc.
Publicize and support the academic policies and standards of
UW-Madison.
Support and participate in the evaluation process of the
Program/Class.
Attend ALL required WISCIENCE training activities and
meeting.
COURSE POSITIONS
RESPONSIBILITIES AND DUTIES
Exploring Biology Peer Mentors


*same as program positions responsibilities and duties*
Peer Mentor for Biology 100:
Exploring Biology
Must enroll in two 1-credit courses.
o Biology 399: Education
Internship
o Biology 375: Exploring
Biology Peer Leadership
Exploring Service in Science Mentors


Peer Mentor for Biology 375, Section
3: Exploring Service in Science
Must enroll in one-credit course.
o Biology 399: Education
Internship
Collaborate with the course instructor to provide instructional
leadership for course.
Meet weekly with the assigned course instructor to assist
her/him in planning the curriculum and instructional activities,
both before the course starts and throughout the semester.
Attend all classroom sessions.
Coordinate with the course instructor to meet with each student
outside of class at least twice during the semester. This time
period should be used to monitor the students’ academic
progress and to intervene with appropriate recommendations
that could assist with the students’ retention and success at
UW-Madison.
Hold 1 to 3 office hours per week (to be arranged in
cooperation with the course instructor).
3|Page
ADVANCED LEADERSHIP OPPORTUNITIES
Peer Leader for Biology 375: Engage Children in Science


Must have successfully completed Biology 375 course prior to Fall 2015.
Must enroll in a one-credit course.
o Biology 399: Service Learning
Bio Commons Assistant



Must have participated in a program or course mentoring position prior to Fall 2015.
Afternoon and evening desk hours at the BioCommons in Steenbock Library.
Paid position: 6-10hrs per week
Entering Research Mentor



Peer Mentor for Biology 260 & 261: Entering Research Parts 1 & 2.
Must have competed Bio 262.
Must enroll in a one-credit course.
o Biology 660: Entering Mentoring
Undergraduate Research Peer Mentors




Must have participated as an Entering Research Peer Mentor prior to Fall 2015
Evening drop-in research peer mentoring at the BioCommons in Steenbock Library
Must enroll in a one-credit course.
Paid position: 2-4hrs per week. Tues/Wed evening hours.
A more detailed description of each program can be found online at www.biology.wisc.edu
MANDATORY IMPACT PEER LEADER TRAINING DATES: APRIL 24, 25, 26
TIMES TBA


All new Peer Leaders must attend a mandatory Peer Leader Retreat scheduled on
the following days and times: April 24, 25, 26 – Times TBA
Peer Leaders may be subject to a monthly in service training or meeting to be held
during the semester. The dates will be announced at least two weeks in advance.
4|Page
IMPACT Peer Leaders
APPLICATION
REQUIREMENTS:





Have at least a 3.0 cumulative GPA
Have completed a minimum of 24 college-level credit hours at an institution of
higher education by Fall 2015
Be enrolled full-time at UW-Madison (12 or more undergraduate hours) each
semester
Available to attend all training sessions
Have completed one semester of Chemistry
Last Name: Click here to enter text.
First Name: Click here to
enter text.
M.I.: Click here
to enter text.
Address: Click here to enter text.
City, State: Click here to
enter text.
Zip: Click here
to enter text.
Primary Phone #: Click here to enter text.
Email: Click here to enter text.
Major: Click here to enter text.
Minor: Click here to enter text.
Number of credit hours completed: Click
here to enter text.
Cumulative GPA: Click here to enter text.
WISCARD ID#: Click here to enter text.
Are you currently employed on campus? Click here to enter text.
If yes, which department and how many hours do you work? Click here to enter text.
How did you hear about this position? Click here to enter text.
Please check the positions you would like to be considered for. You make check more than
one.
Program Positions
Course Positions
Advanced Leadership
MadBiology Boot
Entering Research Mentor
Co-Instructor for Engage Children
Camp Counselor
(fall & spring)
Science (fall & spring)
(pre-fall)
Exploring Service in
BioHouse Assistant (fall & spring)
Science Mentor (spring)
Entering Research Mentor (fall &
spring)
Undergraduate Research Peer
Mentors (fall & spring)
5|Page
Recommender Release Form
Click here to enter text.
Click here to enter text.
Name of Applicant
Date
Click here to enter text.
Click here to enter text.
Name of 1st Recommender
Email Address
Click here to enter text.
Click here to enter text.
Name of 2nd Recommender
Email Address
Click here to enter text.
Signature (provide your full name if electronic signature)
By signing the form above, I authorize WISCIENCE to request information from
references concerning my work performance and general character. I further
authorize the faculty or staff member receiving this form to give complete
information as requested by WISCIENCE. I understand that the information
requested will not become part of my student file at UW-Madison and that such
information will be treated as confidential.