Stan State Health Careers Pathways Mentor Application

Complete and submit directly to Dr. Mark A. Grobner (mgrobner@csustan.edu).

PERSONAL INFORMATION (type or print) E-mail

Name:

(Last)	(First)	(MI)

Cell Phone: () -	Permanent Phone: () -

Local Address: Apt #

City: State: Zip:

Permanent Address:

City:	State:

EDUCATION

Classification: junior senior

Major(s):Minor(s):

GPA:	Expected Graduation Month/Year:

Career Goal:

Why do you want to become a peer mentor?

Describe any other activities that you have been involved in that relate to this position, esp. anything you have done that involved tutoring or mentoring of others.

What advice would you give to incoming freshmen?