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Apply to be a Mentor

Please limit your responses to NO MORE THAN 50 words to each question.

This application is for students who wish to participate as mentors in the PAM program. Please submit your responses by January 29, 2018.

Last Name: First Name: Middle Initial:

Nickname: Student ID:

Male Female  Other  (optional)

How do you racially/ethnically identify: 

Graduation year: 

Permanent address:

UR Email:


Major: GPA:

Do you tend to be:

 Introverted or  Extroverted

Check your top three hobbies/interests: 




Type of listening 




 Cultural events (plays, poetry, etc.)

 Sporting events

 Outdoor events (hiking, kayaking, rafting, fishing, etc.)

 Community Service

 Drama (acting, writing, set production)

 Debate (Model UN, Mock Trial)





Activities and commitments for fall and spring semesters (e.g., resident assistant, study abroad, employment, senate, etc.). If studying abroad (or have applied to study abroad), state semester (e.g. fall, spring) and whether you are accepted or applying:

List all leadership positions:

Briefly describe your interpersonal skills (i.e., verbal & non-verbal communication, listening, negotiation, problem-solving, decision-making, assertiveness, etc.):

What qualities or skills do you have that would benefit an incoming first-year student?

Based on your first-year experience, what one thing would you advise a mentee to do or not do?

Why should you be selected to be a mentor?

Gender preference for your mentee:
Male Female  Other  No Preference

I am interested in assuming a leadership position. 
Yes No

If No, please certify and submit at the bottom of the form.  

If Yes: 

There are a limited number of Co-Chairs, and their roles include communications chair, social media chair, academics chair, social chair, community service chair, and the Family Cluster chair. These Co-Chairs help organize, plan, and implement PAM events. They maintain the communication with the PAM community throughout the year and for all events. They also provide more general leadership to mentors and mentees within the program. 

Please select the two (2) leadership roles you would be most interested in.  

Co-Chair Positions: Communications Chair, Academic Chair, Social Chair, Community Service Chair, Social Media Chair, Family Chair Leader

 Communications Chairs:  The chair members are in charge of all emails to be sent out to the members of PAM: i.e. reminders of program events hosted by PAM as well as reminders to all leaders of all upcoming meetings. The Communications Chairs will also be responsible for sending out notes to all appropriate members summarizing what transpired in any meetings. They will also work closely with the Academic Chairs, Social Chairs, and Community Service Chairs so that they kow when all events are occurring and so that emails can be sent accordingly.

  Academic Chairs:  The role of the Academic Chairs is to promote and advertise all academic and leadership events that are happening on campus. This includes, but is not limited to, workshops, retreats, conferences and leadership opportunities for students that are offered by student and university organizations.

The Academic Chairs are also responsible for coordinating with the Director and Associate Director of PAM in organizing the Leadership Training Workshop that will be held in the spring semester.

The Academic Chairs will work closely with the Communications and Social Media Chairs to make sure that their events are advertised well in advance of the actual event date.

 Social Chairs:  The role of the Social Chairs is to organize and lead all of the program events involving all the members of PAM. They will be in charge of coming up with ideas for the schedule and location of the events. The main goal of these events is to introduce the mentees and mentors to other PAM members outside of their family clusters. Thus, the Social Chairs will interact with all members of PAM, executing activities that support PAM mentees and mentors.

The Social Chairs will work closely with the Communications and Social Media Chairs to ensure that their events are advertised well in advance to create interest and support strong attendance.

 Social Media Chairs:  The role of the Social Media Chairs is to maintain and update all social media associated with PAM. This includes the Facebook page, Instagram account, and SnapChat account. The Social Media Chairs are responsible for taking pictures at PAM events. All pictures taken in PAM should be directed via Box folder to the Social Media Chairs so that they can post the pictures and advertise PAM. The Facebook posts will serve as reminders as well as an advertisement of the events and activities that mentors and mentees are involved in to increase support and attendance. The SnapChat account will serve as reminders for the members of events approaching and depict what went on at the program events. The Instagram account will be used as an advertisement to encourage potential mentors and mentees to join PAM.

These Chairs will work closely with the Social, Academic, Communications, and Community Service Chairs to advertise all events that these Co-Chairs are promoting. The Social Media Chairs will also work closely with the Director and Associate Director of PAM relative to events they wish to advertise.

 Family Chair Leaders:  The role of the Family Chair Leader is to make sure that all Family Cluster Leaders are solidly executing their jobs. They will hold meetings about once a month to get an update from the Family Cluster Leaders about the status of their Family Clusters and what they have done for the family events. The Family Chair Leaders will handle any issues with family clusters or direct the problem to the directors of the PAM program.

 Community Service Chairs: The role of the Community Service Chairs is to organize the two community service events that PAM hosts each semester: the Trick or Treat Street (TOTS) event in the fall and the Boys and Girls Club event in the spring.

The Community Service Chairs will work closely with the Social Media and Communications Chairs to make sure that their events are advertised well in advance.


 I would like to be considered for a Family Cluster Leader position.

The primary responsibility of the Family Cluster Leaders is to organize events for their respective Family Cluster, and secondarily to be a leader and role model for the Family Clusters.

If there are problems in relationships between mentors and mentees or personal problems among the members of the family, the Family Cluster Leader is there to offer support or able to point the person(s) involved in the right direction to get assistance.

Family Clusters are required to have four outings (2 per semester) as a group, and it is the responsibility of the Family Cluster Leader to get as many members of the family involved in the family cluster activities as possible.

Family Cluster Leaders are also responsible for encouraging the completion of online evaluations and attending regular meetings held by the Family Cluster Chair Leader. At these meetings, they will offer feedback on how the mentees are progressing and report on their family events.

 I certify that this information is accurate and that if selected, I will adhere to PAM policies and requirements.


If you have questions about this application, please contact Hope N. Walton, director of academic skills, at or (804) 289-8626.