EmailMe Form - MIPS Peer Mentor Program 2021-2022

The MIPS Peer Mentoring Program (PMP) has matched Black, Indigenous, People of Color (BIPOC) mentors with mentees for over 17 years. Our peer-to-peer mentor program is dedicated to fostering community amongst peers through mentorship, where BIPOC First Year and Transfer students will be supported academically, emotionally, and socially during their first year.

Our Peer Mentors are committed to sharing their personal and academic experiences to encourage, guide, challenge and support new and transfer students in their academic growth, goal achievement, and overall success as a student. We want to ensure that you are connected to a community of support that will guide and empower you to make the most of your experience at St. Kate's. Individuals will be matched on a rolling basis.

Personal Information:

Name *

First MI Last

I identify my gender as:

How do you define yourself (Racially/Ethnically)?

My pronouns are: (Select all that apply) *

What is your St.Kate's email address? *

What is your email address? *

Best phone number to contact you at? *

### - ### - ####

Will you be living on campus during the school year? *

Yes

No

Other

The best way to get a hold of me is through:(Check all that apply) *

What is/are your username(s) for what you checked marked above (so your mentor can add you): *

Are you a first generation college student? *

Yes

No

Other

*First Generation College Student - defined as a student whose parent(s)/legal guardian(s) have not completed a bachelor's degree.

Did you participate in the First Step Institute Program? *

Yes

No

Are you in College Possible? *

Yes

No

How much time would you like your mentor to connect with you per month? *

1-3 hours

4-6 hours

7-10 hours

*NOTE: Neither you or your mentor will be held for this. This question is meant to gage how much you are open to connecting with them *

How did you hear about the mentoring program?

Mentee Profile Questions:

Please answer each question: This information would help us with the matching process and then will be shared with your assigned mentor.

Please tell us why you are interested in the peer mentor program. *

How would you or your friend describe yourself? *

Have you decided on a major? If so please indicate. If not what major/s you might be interested in pursuing. *

Please list a few of your hobbies, interests, leadership opportunities you currently pursue or hope to pursue in college. *

What are the specific characteristics you would want us to consider in matching you with a mentor? What would you hope to gain from your mentor - mentee relationship? (i.e. similar major, race/ethnicity, interests & hobbies, personality type, etc.) *

What excites you about coming to college? What are your fears or concerns about coming to college? *

Anything else you want us to know in order to provide you with a better match?

After reading the Mentors Profiles, please indicate your top 4 preferred Peer Mentors. We will do our best to match you up with your top 4 choices; however we cannot guarantee that you will be paired with one of the four mentors you request.

A description of the section goes here.

1) Name of Mentor: *

2.) Name of Mentor: *

3.) Name of Mentor: *

4.) Name of Mentor: *

Briefly share your reason why you want to be matched these mentors:

Mentee Responsibility Agreement:

The Peer Mentor program provides each mentee an encouraging and caring mentor, prompts to utilize and engage in the academic & social support services which focus on developing or enhancing strategies for success. A successful mentee/mentor relationship requires a commitment on the part of both partners. In addition, these are the responsibilities and expectations of the student mentees.

As a mentee I agree,
1. To attend the beginning of the year mentee & mentor gathering
2. To actively participate in events and programs sponsored by the MIPS peer mentoring program.
3. To let my mentor know when I am experiencing academic or personal difficulties.
4. To keep in regular contact with my mentor according to the program guidelines.
5. To be prompt and keep scheduled meeting with my mentor (minimum twice a month or in person)
6. To participate in program evaluations and follow up requested by my mentor or the coordinator of the peer mentor program.
7. To understand I should communicate with the PMP coordinator if issues arise with my mentoring relationship. I may request to be assigned a different mentor if my current mentor and I cannot work effectively together as a team.
8. Be open-minded and willing to meet and learn from each other as well as fellow peers in the program.

Student Name *

First Last

Student Signature *

Clear