Peer Mentor Program

Personal Information

Name:                      Permanent Address:      
Local Address:                      FSU ID      
E-Mail Address:                     Permanent phone:                     Program:      
Local Phone:                     Male:        Female:  

Personal Characteristics

Career Goals
Are there specific characteristics you would want us to consider in matching you with a mentor?
Is ther other information about yourself that would help us match you?
What do you expect to gain from this program?
Which of the following student services are you most interested in? Check as many as needed   Tutoring                                         Time Management     
  Academic Program Planning           Test-Taking     
  Career Assessment / Planning         Learning Style     
  Stress Management                        Study Skills

Program Information

Class Standing   Freshman        Sophomore        Transfer
Program / Major / Curriculum
Will you work this semester?         Yes        No            If yes, how many hours per week?