O.W.L. Academic Peer Assistance
Application
Student ID: ______Today’s Date:______
First Name: ______Last Name: ______
Home Address: ______
City: ______State: _____ Zip: ______
PGCC Email: ______
Home Number: ______Cell Number: ______
Current PGCC Cumulative G.P.A. ____ #of Credits Earned at PGCC: _____
Current Major: ______PGCC Anticipated Graduation Date:______
One Reference (please do not include family members):
Name Relationship Phone
Which shift are you available for work? (Please select one shift).
Morning shift: 9:00am – 12:00pm
Afternoon shift: 12:00 Noon – 5:00pm
Evening shift: 5:00pm – 8:00pm
REFLECT & RESPOND TO THE FOLLOWING QUESTIONS
1. What qualities can you bring to the O.W.L. APA Program? Please be specific and provide examples.
2. What do you think every new student should know about starting college and adjusting to a new learning environment?
3. What do you think are the most important characteristics of being a successful student and why?
4. Why is being an Academic Peer Assistant (APA) important to you and what do you hope to accomplish as an APA?
STUDENT SERVICES
ADVISING AND TRANSER SERVICES
301 LARGO ROAD
LARGO, MD 20774-2199
(301) 322-0151
Fax (301) 583-5222
Prince George’s Community College
College Work-Study (CWS) Program / Volunteer
Student records must be maintained in strict confidentiality. They are protected by both the Federal Family Educational Rights and Privacy Act (20 U.S.C. Sections 1232 et seq.). Except as specifically permitted by law, no person other than the student named in a record may have access to the records. All other person must obtain written permission signed by the student authorizing the release of information. No volunteer, student assistant, work-study or non-supervisory employee may release confidential information without discussing the request with his or her immediate supervisor first. Failure to comply with the requirements of this policy may result in disciplinary action, including loss of student college work-study / volunteer status. Furthermore, a breach of confidentially is just cause for immediate dismissal from your employment or volunteer position.
Confidentiality Form
I, ______S.S.# ______, as a full-time or part-time volunteer or student work-study of Prince George’s Community College, have read and understand the Advising and Transfer Services Confidentiality Statement as outlined above. I agree to comply with this policy. I will exercise caution in handling confidential student record information, including, but not limited to student reports, memos, grade reports, GPA information, computer terminal screen displays, etc.
I understand that violation of this agreement may constitute a basis for termination of my employment, volunteer status, and/or termination of my student status.
I have reviewed the Confidentiality Policy with the above student
Date O.W.L APA Coordinator
I have reviewed the Confidentiality Policy and the attached General College Work Study/Volunteer student responsibilities with my O.W.L APA Coordinator and fully understand its premise and legality.
Date College Work Study Student / Volunteer
STUDENT SERVICES
ADVISING AND TRANSER SERVICES
301 LARGO ROAD
LARGO, MD 20774-2199
(301) 322-0151
Fax (301) 583-5222
General Responsibilities for College Work-Study / Volunteer
Student employees and volunteers are required to comply with the performance standards established by the department for which they work. Students who fail to perform in a satisfactory manner may be removed from their assignment and from the work study or volunteer program.
Any student who accepts a work study or volunteer position accepts the responsibility of maintaining professional standards and agrees to the following:
Please read and initial each statement.
______1. Perform his or her job assignment in a serious and responsible manner. College work-study / volunteer students are required to adhere to the following rules and policies regarding the
privacy and confidentiality of student records information.
______2. Student records are not to be removed from any college office by college study-work /
volunteer students unless requested to do so by the appropriate supervisor.
______3. College work-study / volunteer students who are granted access to student record information
are accountable for the protection of the information and its contents while it is in their
possession.
______4. College work-study / volunteer students are prohibited from accessing or discussing personal
record information for their friends or peers.
______5. College work-study / volunteer students should not use college equipment or office supplies for
personal reasons, except as designated by a supervisor.
______6. College work-study / volunteer students are prohibited from working with their own records.