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Peer Mentor Application
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Student Forms
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Peer Mentor Application
If you are interested in becoming a peer mentor at Bismarck State College, please complete the Peer Mentor Application.
* Today's Date (MM/DD/YYY)
this field is required
First Name
Last Name
* BSC Student ID#
this field is required
* Local Address (while attending BSC)
this field is required
* BSC Email Address
this field is required
This email is invalid
* Phone Number (XXX-XXX-XXXX)
this field is required
* Residence Hall
You need to check this item to proceed.
Gate City Bank Hall
Lidstrom Hall
Mystic Hall
Ritchie Hall
Swensen Hall
Werner Hall
Off Campus
* What program/degree are you pursuing?
this field is required
* Classification
You need to check this item to proceed.
Freshman
Sophomore
Junior
Senior
* GPA
this field is required
* Anticipated Graduation Semester/Year (Ex. Spring 2022)
this field is required
* What student resources are you familiar with and/or plan to use at BSC? Please briefly describe.
this field is required
* What activities do you plan to participate in at BSC?
this field is required
* Why are you interested in being a BSC Peer Mentor AND why are you a good candidate?
this field is required
* What experience do you have as a peer mentor, in a Peer-to-Peer program and/or working with peers who have a disability? What value did you find in these experiences?
this field is required
* Describe your leadership experience and overall leadership experience and how it relates to a peer mentoring position at BSC.
this field is required
* List 3 References (Name, Contact Info, Relationship)
this field is required
* Would you prefer this peer mentorship position be:
You need to check this item to proceed.
Student Employment
Work Study
Volunteer
Other
* I certify all information included in the application is correct and true to the best of my knowledge.
You need to check this item to proceed.
Yes
No
* I am able and willing to provide proof of eligibility to work in the United States at the time of hire.
You need to check this item to proceed.
Yes
No
* I herby authorize staff in the Student Success Program to access my academic and judicial records.
You need to check this item to proceed.
Yes
No
*After you complete the peer mentor form (above), you also need to complete the online application through our
Student Employment webpage
. (Scroll down to Student or Work-Study Peer Mentor.)