Teagle Undergraduate Student Mentor Application By lmeaderds • March 10, 2021March 10, 2021 All Student Mentor applications are due by Monday April 5, 2021, 11:59PM CT. Teagle Undergraduate Student Mentor If you are human, leave this field blank. Name * First/Middle/Last Preferred Name Email Address * Gmail Email Address (If Applicable) Are you a College Prep Alumni Scholar or past/current Program Assistant? * No Yes Washington University Student ID # (If a CPP Alumni Scholar and not a WashU student, type 000000) * Contact Information School/Current Address * School/Current Address Address Line 1 Address Line 1 Address Line 2 Address Line 2 City City State/Province State/Province Zip/Postal Zip/Postal Country Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Colombia Comoros Congo Costa Rica Côte d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria Norway Northern Mariana Islands Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Sudan Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Yemen Zambia Zimbabwe Country Permanent Address * Permanent Address Permanent Address Permanent Address City City State/Province State/Province Zip/Postal Zip/Postal Country Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Colombia Comoros Congo Costa Rica Côte d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria Norway Northern Mariana Islands Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Sudan Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Yemen Zambia Zimbabwe Country Cell Phone * Washington University School/College * Sam Fox School of Design & Visual Arts Olin Business School McKelvey School of Engineering Arts & Sciences University College Other (Alumni Scholar Not Attending WashU)Other (Alumni Scholar Not Attending WashU) Major/Concentration * Minor, if applicable Attendance Status * Rising Sophomore Rising Junior Rising Senior Current Senior Anticipated Graduation Date * Please note: All Washington University candidates’ records will be verified with the office of Student Conduct and Community Standards to determine positive standing with the University. Positive standing will be determined by the office of Student Conduct and Community Standards. Short Answer Essays Please answer the following questions. (minimum of 80 words per question) 1. Please share your experiences with working with a diverse background of students (ex. first generation, students of color, and students with limited financial resources)? * 2. What program/session ideas do you have for engaging College Prep Scholars in academic enrichment, hands-on activities and social engagement? * 3. As a Student Mentor, what challenges do you anticipate experiencing in the Washington University College Prep Program (working with youth, community related, personal)? * References List two references that we are able to contact. Undergraduate students (peers, mentors, etc) are able to provide references, however, you are only allowed to list one peer. *Note: current, former, and alumni College Prep staff (director, program coordinator, administrative coordinator, graduate fellows, program assistants, and office assistants) are not allowed to be listed as reference. Reference #1 Name * First & Last Name Title * Relationship to Reference * Phone * Dates Known * Email * Reference #2 Name * First & Last Name Title * Relationship to Reference * Dates Known * Phone * Email * Résumé Please upload a .doc or .pdf of your current résumé. File Upload * Uploading Files. Please Wait. Drop a file here or click to upload Choose File Maximum upload size: 51.2MB Selection Process: Qualified candidates will be invited to an hour-length interview. Those interviewing will receive a confirmation email of their interview date and time. Please select all days and times you are available. Mondays (please check all that apply) 9am 10am 11am 12pm 1pm 2pm 3pm Tuesdays (please check all that apply) 9am 10am 11am 12pm 1pm 2pm 3pm Wednesdays (please check all that apply) 9am 10am 11am 12pm 1pm 2pm 3pm Thursdays (please check all that apply) 9am 10am 11am 12pm 1pm 2pm 3pm Fridays (please check all that apply) 9am 10am 11am 12pm 1pm Electronic Signature Completed applications include this application form, essay responses and a resume. Please type in your initials below and click the box to signify your applicant signature. * Please type in your initialsPlease type in your initials Signature This form is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. Submit