PEER MENTORSHIP
Faculty of Health Sciences
FHS Peer Mentorship Program 2013/2014
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 July 27th? Describe any pre-booked
summer plans you have.
___________________________________________________________________________________
I can make a two-semester commitment (Fall 2013 & Spring 2014):
 Yes
 No
Have 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
If you have been a mentor for at least one year and are interested in applying for the additional “Team
Leader” Position, please indicate your interest here:
 Yes, I would like to be considered for the Team Leader position and have thoroughly
read through the roles & responsibilities of the position (refer to mentorship website)
**Please answer the Team Leader specific questions at the end of this application
 No, I am not interested in the Team Leader position and/or I have not been a mentor
before
PEER MENTORSHIP
Faculty of Health Sciences
Please answer the following questions as completely as possible.
1) Why do you want to be a Peer Mentor (if you were a mentor last year, why do you want to be
one again)?
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 (or that helped you succeed as a Peer Mentor last year).
PEER MENTORSHIP
Faculty of Health Sciences
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.
5) New Applicants: What would you bring to the Peer Mentorship Program?
Returning Applicants: Describe how you plan to improve upon your mentorship experience
from last year.
Future Career Plans:
To the best of my knowledge, the information on this application is complete and honest.
Name (does not have to be handwritten) __________________________________
Date ______________________
Due April 15th – Attach this application form & a copy of your Resume in an email to fhspeer@sfu.ca
PEER MENTORSHIP
Faculty of Health Sciences
Team Leader-Specific Questions
**Only answer if you would like to be considered for the Team Leader Position
1) If you could give one piece of advice to a new Mentor, what would it be?
2) Describe what experiences/previous positions you have had that would help you be a good role
model for new mentors?
3) Describe your experience with event planning. What ideas do you currently have for events you
could organize for your assigned group of mentors/mentees?