Skip to main content

Peer Mentor Application | Bismarck State College

to the top of the page
Home Page
  Home  »  Student Forms »  

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)  
First Name
Last Name
* BSC Student ID#  
* Local Address (while attending BSC)  
* BSC Email Address   
* Phone Number (XXX-XXX-XXXX)  
* Residence Hall  






* What program/degree are you pursuing?  
* Classification  



* GPA  
* Anticipated Graduation Semester/Year  (Ex. Spring 2022)  
* What student resources are you familiar with and/or plan to use at BSC? Please briefly describe.  
* What activities do you plan to participate in at BSC?  
* Why are you interested in being a BSC Peer Mentor AND why are you a good candidate?  
* 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?  
* Describe your leadership experience and overall leadership experience and how it relates to a peer mentoring position at BSC.  
* List 3 References (Name, Contact Info, Relationship)  
* Would you prefer this peer mentorship position be:  



* I certify all information included in the application is correct and true to the best of my knowledge.  

* I am able and willing to provide proof of eligibility to work in the United States at the time of hire.  

* I herby authorize staff in the Student Success Program to access my academic and judicial records.  

*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.)