Peer Mentor Application Form Today's Date* Date Format: MM slash DD slash YYYY Student InformationStudent Name* First Last Best Contact Number*UTK Email* Enter Email Confirm Email Major*Is this your first time being an SDS peer mentor?*YesNoPlease indicate the semesters you've served as a peer mentorPlease explain why you want to become a peer mentor for Student Disability Services.*What are your interests and hobbies?Please list any campus groups or organizations in which you are involved?What qualities do you possess that would help you be an effective peer mentor?*Please describe your understanding of what will be expected of you as a peer mentor, both in time commitment and the ways in which you will assist students.*How do you think being a peer mentor will benefit you?*Please note any preferences you have in terms of the characteristics of mentees you may be assigned, (e.g. gender, disability, major, etc.).If we have more students to be mentored that we have mentors, would you be interested in mentoring more than one student? (There is no requirement that you do so.)*YesNoI commit that I will: * Attend a required mentor training in spring 2020 * Meet with my mentee once per week for about an hour throughout the fall 2020 semester * Attend at least one program or event with my mentee during the fall 2020 semester * Maintain a log of my meeting and service hours * Report to SDS staff any issues or concerns throughout the mentoring relationship * I understand the information contained in my interest form may be shared with my mentee(s). I agree not to share or disclose any information related to my mentee with others, except as necessary with the SDS staff for purposes of managing the mentor/mentee relationship. PhoneThis field is for validation purposes and should be left unchanged.