EXCEL Mentor Application

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Application Process: Please read carefully

Complete the application below by 5:00 pm Thursday, April 12th.

If you have any questions please contact Bobby Steele at 765-285-1344 or bdsteele@bsu.edu

For Your Own Reference:

Excel Mentor training: August 12th -15th
Excel Mentee arrival: August 15th
Excel Dates: August 15th - August 17th

First Name: *

Last Name: *

BSU ID: *

Ball State E-mail: *

@bsu.edu

Cell Phone *

Major: *

Minor:

Cumulative GPA: *

Your GPA will be verified for eligibility, applicants must have a 2.5 or higher at the time of application.

Gender: *

Current Year: *

T-shirt size

2XL

3XL

Clear selection

Please list any campus/community organization involvement or employment. *

Are you a new or returning mentor applicant? *

New applicant

Returning applicant

Why are you interested in becoming an EXCEL mentor? *

References:

Please list two professional references, at least one should be a Ball State staff/faculty member.

Reference 1: *

Must include first and last name, title, telephone number, and email.

Reference 2: *

Must include first and last name, title, telephone number, and email.

Would you be interested in serving as a REACH mentor during fall 2020?

Your selection does not impact your candidacy.

Yes

Clear selection

Statement of Understanding:

I understand I must be enrolled at Ball State University and be classified as a sophomore or higher by August 2021. I also understand that I must have a cumulative GPA of 2.5 or higher and be in good judicial standing with the Ball State University. If selected as a mentor I must agree to the following terms:

1. I must be present at all training dates and throughout the duration of the program.
2. Maintain a minimum of a 2.5 GPA until the end of the spring semester 2016.
3. Remain in good judicial standing with the university.

If you affirm that you have provided accurate information on this appliation and agree to the above conditions please check the box below: *

I hereby confirm that the information provided is accurate and I agree to the conditions listed above.

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