This application and two faculty recommendations are due by 15 May 2009.  Please contact Dr. Chewning or Sara Lacagnino if you

have any questions.  Please print all three forms and be sure they are returned by 15 May.

Name: _________________________________________________________________

Mailing Address: _________________________________________________________

_______________________________________________________________________

Email Address: ___________________________________________________________

(Please keep in mind that you are also expected to use your UCC email account as part of your participation in the UCC 101 program.)

Please name two professors/staff members at UCC from who you will be requesting letters of reference (see attached form): _______________________________________________________________________

________________________________________________________________________

Did you take UCC 101?     yes                     no

If yes, describe your experience in the course (both positive and negative):

Have you had any experience working with students as a peer mentor or tutor?  If so, please explain:

What is your major?

What is your chosen career or profession?

Where do you plan to transfer after graduating from UCC?  Why?

The main topics addressed by the UCC 101 course are time management, reading and writing skills, study and test-taking skills, career and major selection, and faculty/student relations.  Based on this list, which of these topics do you think are your strongest?  Explain.

What do you see as the greatest strength or talent that you will bring to UCC 101 and your position as a mentor?