skip to content

MENTEE APPLICATION
Priority Application Deadline: Friday, May 16, 2014

Thank you for your interest in the SUCCESS Mentoring Program. This program is designed for first-generation college students and anyone who desires extra support in order to complete their goal of academic and personal success. Please complete the form below and be thorough in your responses. Notification will begin May 21, 2014 and continue until all spots are filled.

* required field

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

Are you: (Please check all that apply):*
Commuter Student (living off campus)
Non-Traditional Student (not a recent high school graduate)
First Generation College Student (you are the first in your immediate family (mother/father/legal guardian) to enroll in higher education)
Traditional Student (recent high school graduate)
Transfer Student
International Student
Veteran

How many hours are you anticipating taking during your first semester?*

Do you plan on working during your first semester here at TWU?*

If yes, do you plan on working on campus or off campus?

Do you plan to live on-campus during the 2014-15 academic year*

If so have you completed your housing application?

Please give a short background history of yourself. List any involvement, activities, special hobbies and interests:*

Why do you want to become a member of the SUCCESS Mentoring Program?*

Based on your personal background & information provided about the programs, how do you feel SUCCESS will help you in your first year at TWU?*

What do you expect to gain from having a mentor/being a part of the SUCCESS Mentoring Program?*

Tell us which category you prefer for us to consider for pairing you with a mentor. Rank them in order of preference with 3 being the highest and 1 being the lowest.*
Racial/ethnic background
Hometown/Location
Major
Other

Please addess any questions or comments you ha ve regarding the SUCCESS Mentoring Program here:

All SUCCESS Mentees are REQUIRED to attend all events related to SUCCESS scheduled during the LLC Retreat and 2014 Pioneer Camp in beginning Wednesday, August 20, 2014. More information will be provided upon acceptance into the program. Failure to attend will result in a delay in the membership process. A NON-REFUNDABLE administrative fee of $50 is required of those selected into SUCCESS that will be automatically billed to your student account. Those who are selected to live in the SUCCESS Living Learning Community will pay only one $50 fee to be split between University Housing and Intercultural Services. The information you provided is strictly confidential and will be used in processing your application for membership. The program is limited to 35-40 applicants. For more information please call (940) 898-3679. In accordance with Leg. House Bill 1922, an individual is entitled to request to be informed about the information collected about them, receive and review their information, and correct any incorrect information (Sect. 522.021, 552.023, and 559.004 of the Texas Gov’t code.) The information collected will be retained and maintained as required by Texas records retention laws (Sect. 441.180 of the Texas Gov’t code.)

page last updated 9/15/2014 3:11 PM