| Name: |
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| Cell Phone: |
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| Alternate Phone: |
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| Campus/Local Address: |
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| Simpson Email: |
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| Alternate Email: |
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| Major: |
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| Minor: |
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| Expected Graduation Date: |
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| Classification: |
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| When was your 1st semester at Simpson? (ex. Sp ‘08) |
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| When was your 1st semester in SSS? |
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| Did/do you have an SSS Peer Mentor? |
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| What was most valuable to you about having a Peer Mentor? |
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| Why would you like to be a peer mentor? What strengths/skills do you bring to the position? |
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| What are you involved with both on-campus and off (employment, clubs, organizations)? Other hobbies and/or interests? |
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| What SSS service/program/event have you most enjoyed and why? |
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| What would you change or improve with SSS? |
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