G-Force Mentor Application FormSpring 2014


Center for P-16 Initiatives
Collegiate G-Force Mentor Application


Office Use Only

Received by: ______Date: ______Time: ______

General Information:

Name: ______

First Middle Initial Last

Mailing Address: ______

Street Address Apt. #, If applicable

City: ______State: ______Zip: ______

Home Phone: ______Cell Phone: ______

Email Address: ______

DOB: ______Hometown: ______

Do you speak a language other than English? _____ Yes_____ No

If yes, please specify language and fluency level: ______

Grant Specific Information:

Gender: ______Ethnicity: ______

Are you a first-generation student?_____ Yes_____ No

(First Generation is defined as “neither parent graduated from a four-year higher education institution”.)

Are you eligible for and currently receiving financial aid? _____ Yes_____No

If so, please Specify: (Ex: Pell, loans, grants, work study, athletic or merit scholarships)

______

If not, how are you financing your education?(Ex: Working, Family member assistance, etc.)

______

Education Information:

Degree Program:UndergraduateGraduateOther: ______

Classification: ______Hours Completed: ______

Major: ______Minor: ______

Expected Graduation Date: ______20___Current GPA: ______

How many class hours will you be taking thisFall semester?Summer I? Summer II? ______

What are your career interests? ______

Are you involved in any extra-curricular activities/organizations on campus? __ Yes __ No

If yes, please specify: ______

Will you be holding any leadership/officer positions during the summer? __ Yes __ No

If yes, please specify leadership roles: ______

Current Employment Information:

Are you currently employed:_____ Yes_____ No

If yes, who is your employer? ______

How many hours a week do you currently work? ______

Do you plan on maintaining this employment if hired as a G-Force Mentor?___Yes ___ No

If yes, how do you plan on balancing both jobs if hired as a G-Force Mentor? ______

Do you have any current/previous military experience? _____ Yes_____ No

If yes, please specify dates of service: ______Branch: ______

Previous Employment Information:

Have you previously worked as a G-Force Mentor? _____ Yes_____ No

If yes, where did you work and dates of service: ______

Name of supervisor and contact information: ______

Have you ever been terminated/laid off from a previous employer? _____ Yes_____ No

If yes, what was the reason? ______

G-Force Employment Information:

What is your work availability for Spring 2014?

Sunday / Monday / Tuesday / Wednesday / Thursday / Friday / Saturday

The job of a G-Force Mentor requires travel to high schools and other work sites in the surrounding communities. Will you be willing to travel outside of San Marcos? __Yes__ No

What subjects do you consider to be your academic strengths?______

______

Are you comfortable and willing to tutor students in these subject(s)? ____ Yes ____ No

Please list any prior experience you have with high school students and parents: ______

______

What skills do you possess that would make you a prime candidate for this position? ______

The nature of this work requires us to take extensive precaution in hiring. Because of this, employees undergo thorough criminal background checks through the university and the schools we serve. Are you willing to go through this process? _____ Yes _____ No

Is there any other information you would like for us to know or consider: ______

______

How did you hear about this position? ______

IMPORTANT!!!

These forms MUST be submitted with your application.

Incomplete Applications will not be considered.

  • Resume
  • Contact information for three references:
  • (1) Previous Employer, (1) Previous Professor/ current Texas State faculty/staff, and (1) Personal. (If no employment history, submit contact information of twoprevious Professor/current Texas State faculty/staff.)
  • Official Transcript
  • Academic Advisor’s Contact Information
  • Spring 2014 Class Schedules

Submit ALL required documents to:

Kathy Carter in Brazos Building, Room 111.

Please contact her at (512) 245-8192,

or email to for more information.

Applications will be accepted until all positions are filled. These are highly sought-after student worker positions. We recommend you submit yours as soon as possible.

Good Luck!

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