College of Health and Human Development’s United States Department of Education
CAMINO: Charting Access for Hispanics Majoring In Needed Careers and Occupations in Healthcare
Mentor Application 2016-2017
PROGRAM DETAILS
Purpose
The purpose of the Hispanic Graduate Student Learning Community (HGSLC), also known as our Peer Mentor Program, is to help graduate students from CSUN’s allied health programs within the college of HHD to build a community where they can access academic support, professional development, and service-learning activities, as well as engage in peer mentorship with fun and rewarding networking opportunities.
Funding
This program is made possible by funding from CAMINO: Charting Access for Hispanics Majoring In Needed Careers and Occupations in Healthcare, a United States Department of Education’s Promoting Post-Baccalaureate Opportunities for Hispanic Americans (PPOHA) Program.
What is the peer mentorship program?
The peer mentor program pairs 2nd year/continuing graduate students with 1st year students from their respective HHD graduate programs. Mentors are trained to guide their mentees through the academic year. Mentors help peer mentees transition and feel more connected to the university in meaningful ways.
Who are the mentors?
Mentors are 2nd year or beyond graduate students who are dedicated to guiding others through their respective programs. Mentors know how difficult it can be to take on the graduate student role and transition to the next level. Mentors listen and guide their mentees through the academic year. Mentors serve as positive role models and advocates, guiding students through the academic system, including workforce preparation.
REQUIREMENTS AND SELECTION CRITERIA
Mentor Requirements:
v Completed one year of graduate school and is in good academic standing, minimum 3.5 GPA
v Completed application
v One referral from a CSUN administrator, faculty or staff member
v Attend designated activities* throughout the academic year, as well as meet with and advise their mentees
v Will be paid $15/hr for up to 10 hours a week
*Activities include 2 CAMINO professional development workshops a semester, as well as CAMINO-affiliated events such as the Leadership Speaker Series, network mixers, a local or regional conference, and/or participate in graduate student association meetings.
Selection Criteria:
Students must be enrolled in a graduate degree in one of the following programs under the College of Health and Human Development: Communication Disorders, Environmental and Occupational Health, Gerontology, Health Administration, Kinesiology, Lactation, Nutrition, Physical Therapy, and Public Health. Priority will be given to low-income and/or first-generation graduate students (meaning you are the first student to attend college within your immediate family) and Hispanic/Latino students with a) professional experience or growth potential, b) leadership, c) professionalism and maturity.
PROCEDURE FOR GRADUATE STUDENT APPLICANTS
1. Complete the Mentor Application Form (see form below).
2. Complete the CAMINO Research Assistant/Peer Mentor Supplemental Application
3. Submit a current DPR or copy of unofficial transcripts (no older than 5 days before your application is submitted).
4. Submit a current resume including paid employment, volunteer, community service, or research experience. Please emphasize if you are working, volunteering, or engaged in community service or research, related to Latino/Hispanic populations.
5. One letter of recommendation must be provided. Letter must be from a full-time faculty member in your program.
6. Return all materials to or turn into JD2500 Attn: Cathy Kitinoja no later than Friday, September 9, 2016 at 5:00pm PT.
College of Health and Human Development’s United States Department of Education
CAMINO: Charting Access for Hispanics Majoring In Needed Careers and Occupations in Healthcare
2016 Mentor Program Application
Please type or print the following information:
Please print clearly. Fields marked with an asterisk (*) are required.
*Name (Last, First)______
*Program ______
*CSUN ID# ______
*CSUN Email Address: ______
*Preferred Phone: ______
*Date of Birth (MM/DD/YY): ______
*Gender: £ Male £ Female
*Total college or university units completed (for your graduate degree only):______
*Total semesters at CSUN:______
*Number of units needed to complete your requirements for graduation from CSUN: ______
*Number of units being taken this semester: ______
*Expected graduation date: ______
*GPA: ______(must be at least a 3.5 for all graduate coursework)
Are you the first member of your immediate family to attend college? £ Yes £ No
Ethnicity (check all that apply):
£ Asian/Pacific-Islander
£ Black/African-American
£ Hispanic/Latino(a)
£ Native American
£ White: European Descent
£ White: Middle Eastern Descent
£ Biracial/Multiracial
£ Other (not included above): ______
If you marked “Hispanic/Latino” above, please specify by checking any of the following that apply to you:
£ Latino(a)
£ Spanish origin
£ Chicano(a)
£ Mexican
£ Mexican American
£ Puerto Rican
£ Cuban
£ Salvadoran
£ Guatemalan
£ Other (not included above): ______
*Explain your reason for applying to be a peer mentor.
______
*List your skills, abilities and experiences and how they relate to peer mentoring.
______
*Why is it important for a first year student to have a good role model and mentor?
______
*List any personal hobbies that would help us match you with a new mentee (i.e. sports, reading, attending plays, etc.)
______
*Which of the following areas are you comfortable addressing? (Check all that apply)
£Understanding requirements £Following the graduate plan
£Difficulties with academic program £Balancing school and personal life
£Being a parent/caretaker and student £Professional Networking Opportunities
£Completing comprehensive exams £Completing a thesis
£Financial issues £Internship Concerns
£Finding employment post graduation £Tutoring: if checked, which course(s)______
£Other______
*How did you become aware of the CAMINO Peer Mentor Program?
£CSUN Faculty Staff
£CSUN Student
£Family Campus Day
£Word of Mouth
£CAMINO website
£Graduate Coordinator recommendation
£Campus Advertisement (posters, flyers, etc.)
£Other ______
*How many students would you be able to mentor? £ one (1) £two(2)
College of Health and Human Development’s United States Department of Education
CAMINO: Charting Access for Hispanics Majoring In Needed Careers and Occupations in Healthcare
Mentorship Letter of Reference Form
How long have you known this applicant?
______
What is your relationship to this applicant?
______
.
In considering this application for our scholarship, we solicit your candid evaluation of the applicant's academic capability, research scholarship, leadership experience, and community service.
Superior / Good / Average / Poor / Unable to JudgeAcademic/scholarly aptitude
Dependability
Maturity
Leadership
Professional attitude
Ability to express oneself in writing and verbally
Ability to work with others
Research/scholarly capability or experience
Service to the department
Service to the community
Dedication to or passion for the profession
If possible, please also include a short narrative providing specific comments.
Recommender's Name: ______
Position/Title: ______
Department/Program: ______
Signature ______Date: ______
CAMINO Research Assistant/Peer Mentor Supplemental Application
Student Name:______Date:______
Are you currently employed on the CSUN campus? Y N
If yes, how are you employed?
As a research assistant? Y N
As a student assistant? Y N
As a staff member? Y N
Other (please write in) ______
How many hours do you already work for CSUN? ______
What college to do you work for? ______
Which department?______
What grant?______
Name and contact information of direct supervisor of current position: ______
Start date of current position:______End date (if applicable)______