2021 TPE Academy Coach Application Form
Name:
First Name
Last Name
Preferred name that you would like us to use in communicating with you and for materials such as name badges:
Back
Next
Please indicate your preferred gender pronouns that you would like us to use in communicating with you and for materials such as name badges:
she/her/hers
he/him/his
they/them/theirs
ze/hir/hirs
ze/zir/zirs
I don't use a pronoun
I'd prefer not to answer
Gender Identity:
Agender
Gender non-conforming
Genderqueer
Man
Transgender
Transman or Transmasculine
Transwoman or Transfeminine
Woman
I'd prefer not to answer
Other Gender Identity
Please select one or more options that apply to you; use CTRL + click to select multiple items
If you responded with 'Other Gender Identity" above and you'd like to describe your choice further, please do so below:
Back
Next
Sexual Orientation:
Asexual
Bisexual
Gay
Heterosexual or Straight
Lesbian
Pansexual
Queer
Questioning or Unsure
I'd prefer not to answer
Other Sexual Orientation
Please select one or more options that apply to you; use CTRL + click to select multiple items
If you responded with 'Other Sexual Orientation" above and you'd like to describe your choice further, please do so below:
Racial/Ethnic Identity:
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Multi-racial
Native Hawaiian or Other Pacific Islander
Non-US/International
White
I'd prefer not to answer
Other Race/Ethnicity
Please select one or more options that apply to you; use CTRL + click to select multiple items
If you responded with 'Other Race/Ethnicity" above and you'd like to describe your choice further, please do so below:
Back
Next
Email Address:
Phone Number:
-
Area Code
Phone Number
Back
Next
Current Institution/Organization/Company Name:
Current Position/Job Title:
Back
Next
Please indicate the student affairs functional area that most closely matches your current position:
Academic Advising
Admissions
Alumni Programs
Campus Activities
Campus Safety
Career Services
Civic Learning & Democratic Engagement
Clinical Health Programs
College Union
Community Service/Service Learning
Commuter Student Services
Counseling Services
Disability Support Services
Enrollment Management
Financial Aid
Fraternity & Sorority Life
GLBT Student Services
Graduate & Professional Student Services
Intercollegiate Athletics
International Student Services
Learning Assistance/Academic Support Services
Multicultural Services
Nontraditional Student Services
On-Campus Dining
Orientation
Recreational Sports
Registrar
Residence Life & Housing
Spiritual Life/Campus Ministry
Student Affairs Assessment
Student Affairs Fundraising & Development Student Affairs Research
Student Conduct (Academic Integrity)
Student Conduct (Behavioral Case Management)
Student Media
TRIO/Educational Opportunity
Veterans’ Services
Wellness Programs
Women’s Center
Back
Next
Please indicate how many years you've worked within the student affairs profession (please do not include your undergraduate or graduate-level experience):
Less than a year
1-3 years
3-5 years
5-7 years
7-9 years
10 years +
15 years +
20 years +
Please indicate the highest level of education you've completed:
Associate's Degree
Bachelor's Degree
Master's Degree
Doctoral Degree
Back
Next
Have you attended a TPE on-site or TPE Virtual event as a candidate, employer, mentor, or TPE team member?
Yes
No
Back
Next
Please describe your past engagement with TPE:
Please indicate the last year in which you attended the TPE on-site or TPE Virtual event:
Back
Next
Have you been a mentor or coach through TPE before?
Yes
No
Back
Next
Why do you want to be a TPE Academy coach?
Back
Next
Please describe any relevant past experience you've had with coaching and/or mentoring:
What are some qualities of a good coach or mentor?
Back
Next
What are the top three (3) things you believe candidates should know when they attend the TPE virtual event?
Back
Next
Will you be attending the TPE Virtual Event as a candidate or employer in 2021?
Yes
No
I'm not sure
Are you able to commit to serving as a TPE Academy coach from mid-February to May 2021 and stay in regular communication with your assigned mentee?
Yes
No
Back
Next
Is there any additional information that you would like to share?
Submit My Application
Should be Empty:
Now create your own JotForm - It's free!
Create your own JotForm