P1-P2 Spring-Fall Professional Mentoring Online Form

P1-P2 Spring-Fall Professional Mentoring Online Form
Student Name*
Student UID*
Student Email*
example@example.com
Date*

MonthDayYear
Date
Faculty Mentor Name
Faculty Mentor Email
example@example.com
Please check the box for the Current Semester*

P1 FallP1 SpringP2 FallP2 Spring
1. Participation in co-curricular activities
Participation in co-curricular activities (e.g. volunteer experiences):
Students are required to participate in one co-curricular activity each semester (they may participate in additional ones if they want to Use the College's co-curricular event webpage to view and sign up for co-curricular activities.

Students: Please list your required co-curricular activity below. Be sure to include its name, date, and location:
Name, date, and location*
Students: Please list the name of the event coordinator below. The event coordinator’s signature is no longer required but your faculty mentor can verify your attendance using the online co-curricular event system
Event Coordinator Name*
Date*

MonthDayYear
Date
2. Reflection Assignment
2. Reflection Assignment:
Students are required to write reflections about their required co-curricular event. In particular, each co-curricular event covers one or more key elements from ACPE accreditation Standards 3 & 4.

If you completed this reflection using the online co-curricular system, save the document as a PDF and upload it below. If you did not complete the reflection through the online system, utilize this document to write your reflection and upload it below.

Download Co-Curricular Event Reflection document
Upload Co-Curricular Event Reflection Document

Browse Files

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STUDENT SIGNATURE
Once this form is submitted, a copy of the checklist and all uploaded documents will be automatically sent to your faculty mentor. You will need to contact them by email to set up a meeting to discuss this mentoring checklist. Please note that faculty mentors have many demands on their time and students are expected contact their faculty mentor about scheduling this meeting at least two weeks prior to the submission deadline.
Student Signature*

Clear
Date*

MonthDayYear
Date
Student: Please skip to the end of this form to Submit your form now. A copy of your submission will be sent to your email and to your Faculty Mentor.
Mentor Meeting Discussion and Faculty Signature (this section will be completed by the faculty mentor during the meeting with the student)
Note to faculty mentor: All students are required to meet with their faculty mentors to discuss and review the following required items during both the Fall and Spring Semesters of the P1 and P2 years. If you feel that the student has satisfactorily completed items 1 and/or 2, please check the appropriate check boxes below:
The following items must be discussed during the faculty mentor meeting:
Co-Curricular Event Reflection
By signing below, I am confirming that I have discussed and provided feedback on each of the required items identified above.
Faculty Mentor's Signature

Clear
Date

MonthDayYear
Date
Please indicate whether or not the student contacted you at least two weeks prior to the submission deadline to schedule a meeting.

YESNO
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P1-P2 Spring-Fall Professional Mentoring Online Form

1. Participation in co-curricular activities

2. Reflection Assignment

STUDENT SIGNATURE

Mentor Meeting Discussion and Faculty Signature (this section will be completed by the faculty mentor during the meeting with the student)