Peer Mentorship Application Form

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Peer Mentorship Application Form

Welcome to the CCIE Peer Mentorship Program 2024-2025 Application!
How many academic quarters have you completed at Highline College?*

0 (this is my first quarter)1234+Transfer student (first quarter at Highline)

You are eligible to be a peer mentor!

Our program is guided by three core values:
- Affirm Identity: Exploring the complexity of intersecting identites while empowering their authentic selves.
- Build Community: Giving students the opportunities to create meaningful relationships with diverse communities on campus.
- Cultivate Leadership: Providing students different leadership opportunties/roles so students can explore what leadership is for them.
Note: Please submit your application by October 31st, 2024, at 11:59 PM.
You are eligible to be a peer mentor!

Please note that our peer mentorship applications will open in Spring - Summer 2025.
Would you like to be considered for a peer mentor role?*

Yes, I want to be a peer mentor and mentor someone else!No, I would like to find a peer mentor to mentor me!Other

Sign up to be a mentee!

We understand that navigating college can be challenging, and our program is dedicated to supporting you on your journey toward achieving your goals.

Our program is guided by three core values:
- Affirm Identity: Exploring the complexity of intersecting identites while empowering their authentic selves.
- Build Community: Giving students the opportunities to create meaningful relationships with diverse communities on campus.
- Cultivate Leadership: Providing students different leadership opportunties/roles so students can explore what leadership is for them.
What are you looking for in a peer mentor?*
What are some skills, experiences and lessons you hope to take away from this program?*
How do you define your identity? (Feel free to share your background through a brief written response, video, image, or poem.)*
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Personal Information:

Please provide your personal details for identification and communication purposes.
First name*
Last name*
Student ID number*
Email*
Primary telephone number
Birthdate
What is your gender identity?*

FemaleMaleNon-binaryPrefer not to sayOther

Education

Please provide your educational background. It's okay if you have no decided yet.
Interested Major*
Other Course
Current grade point average (GPA) *
Please list any additional languages you speak
Please select all that apply to you*

International StudentFirst Generation StudentTransfer studentPart-time studentVeteran studentRunning start studentOther

About the Peer Mentorship Program
As a peer mentor in the CCIE Peer Mentorship Program, your main responsibilities include:
1. Be currently enrolled at Highline College with a GPA of 2.5 or higher.
2. Attend training sessions from November 2024 -January 2025.
3. Meet with your mentee 2-3 times monthly from February to June 2025.
4. Attend at least one CCIE or CLS event with your mentee or independently.
5. Join the End of Quarter Celebration for the CCIE Peer Mentorship Program.
Note: Accepted applicants will receive a $400 stipend over the 2024-2025 academic year. International students with an SSN are eligible to apply.

For more information, please visit our CCIE and CLS websites.
As a mentee in the CCIE Peer Mentorship Program, here are a few expectations:
- Meet with your peer mentor 2-3 times a month and take the initiative to reach out.
- Be open to networking, attending events, and sharing your experiences with your mentor.
- Maintain confidentiality regarding the information shared during your meetings.
- Reach out to the Mentorship Programs Leadership Advisor if needed.
Please select an option*

I have read and agree to all expectations.I have questions about some expectations.I do not agree to the expectations.

Personal Reflection

Share your motivations for applying to the CCIE Peer Mentorship Program and what you hope to gain. Reflect on your personal growth and how you can contribute.
Why do you want to be a peer mentor, and what do you hope to achieve in this role?*
What does leadership mean to you, and how do you demonstrate it as a peer mentor?*
How do you define your identity? (Feel free to share your background through a brief written response, video, image, or poem.)*
Cancelof

You are eligible to be a peer mentor!