Please answer the following questions (typed responses):

On a scale of 1-4, with 4 being the best, give an honest assessment of yourself in the

space provided.

Your leadership experience ______

Your ability to get along with peers in a group/work setting: ______

Your punctuality ______

Your communication skills ______

1.  Please complete the statement:

An effective HSLI Mentor is someone who (fill in the blank)? How would you fulfill this?

2.  Why would you like to be an HSLI Mentor? What might you do to improve/make the most of the experience/time with the high school mentees?

3.  What would be your largest priority in this role? Why?

4.  What aspect of leadership are you most passionate about? Explain.

5.  Describe some current leadership opportunities you are engaged in.

6.  What is your leadership style? How might this hinder or help you in the role as a mentor?

7.  Who is someone in your life that looks up to you? Why do you believe this person looks up to you/how are you a role model for them?

8.  Do you have any conduct violations? If so, please explain. Please note that answering ‘yes’ to this question does not immediately disqualify you from the selection process for this position.

Please give the attached candidate recommendation form to an on-campus reference (examples include: faculty member, student employment supervisor, coach, Area Coordinator).. The recommendation must be returned directly to Ashley Lang, Director of Campus Programming (Student Life Suite) by Friday, November 18, 2016.

Reference Name Relationship Phone

HIGH SCHOOL LEADERSHIP INSTITUTE MENTOR RECOMMENDATION FORM

Thank you for taking time to complete this form. Please complete & return by Friday, November 18, 2016 to Ashley Lang, Director of Campus Programming & Assistant Director of the Institute for Leadership Education (Student Life Suite). Please email questions to .

Name of Applicant ______

Name of Reference ______

Reference E-mail ______Reference Phone ______

Relationship to Applicant ______

HSLI Mentors are a vital part of the HSLI Mentee experience at Wartburg College. These students will have the responsibility of serving as mentor for 2-3 high school students for an academic year. Mentors are a part of a team who assist in the planning, coordination, implementation and evaluation of HSLI, a summer institute for high school seniors to study and practice leadership skills and service as a form of community and civic engagement. Please assist us in our selection process by providing an honest appraisal of the applicant’s strengths and weaknesses.

0 1 2 3 4 5

Uncertain/unable Qualities Qualities need Average Above average Superior

to observe insufficient improvement qualities qualities qualities

This student has a positive attitude: 0 1 2 3 4 5

This student is able to communicate

his/ her thoughts well: 0 1 2 3 4 5

This student is motivated in approaching

new situations and able to carry

work through to completion: 0 1 2 3 4 5

This student would be a good representative

of the Wartburg community: 0 1 2 3 4 5

This student can succeed in both individual

and group settings: 0 1 2 3 4 5

I recommend this student as an HSLI Mentor:

___Highly Recommend ___Recommend

___Recommend w/ Reservations ___Do Not Recommend

Please provide any additional comments that might be helpful in our selection process.

Attach a separate piece of paper if necessary.