First Year Peer (Mentor) Leader Application
All applicants must have at least sophomore standing with a minimum cumulative GPA of 3.0
Please include a resume with your application materials
Legal Name: _______________________________________
UWP ID #_____________________
Present Address: _____________________________________________________________
Address City, State Zip
Permanent Address: ___________________________________________________________
Address City, State Zip
Campus Phone #______________________
Cell Phone # ______________________
Email Address: ____________________________________________
Education
Current Class Standing: SO JR SR
Current Cum. GPA: ______________ Spring ‘06 GPA: __________
Declared Major/Minor ____________________________
Academic Certificates (if any) _______________________
Work/Volunteer Experience
Employer Position Dates Employed
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Leadership Experience
Please list any activities or leadership experiences you have or are currently participating in:
References (Two references should be from UWP faculty or staff, reference forms attached)
___________________________________________________________________
Name Professional Title Phone #
___________________________________________________________________
Name Professional Title Phone #
___________________________________________________________________
Name Professional Title Phone #
By signing below, I am certifying that:
1) all of the information provided here is accurate.
2) If chosen, I can make a semester commitment.
3) I give permission for my GPA to be verified.
Signature___________________________________________________
Date ___________________________
Essay Questions
Please answer the essay question as honestly and completely as possible. Feel free to submit your responses on separate paper if you choose to type your answers.
1) Describe how your extracurricular activities, classes, leadership experiences and/or volunteer work will contribute to your success as a Peer Leader.
2) How will you handle situations or information on topics that you find personally difficult
or that challenge your personal values/belief system.
Return application by April 3, 2008 to: Mary Louise Edwards
First Year Experience
900 Wood Road, Kenosha, WI 53141
262.595.2395
edwards@uwp.edu
Wyll D 175
To download a copy of this application in MS Word, click here.
