Mosaic Mentor Program Application

Full Name *

First

Last

Email Address *

Cell Phone Number

Campus Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Home Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Resident or commuter?

Class Year

I am:

Current GPA *

Major(s) *

Minor(s)

T-Shirt Size *

Please list leadership activities you have been involved involved attending LVC or prior: *

Anticipated activities/employment for the fall semester (I.E. student teaching, sports, internships, student organization leadership, etc.): *

Why are you interested in being a Mosaic Mentor? *

What do you hope to gain from the Mosaic Mentor Position? *

What do you feel are 3 major issues facing first year multicultural students here at LVC? Please explain. *

Explain the contributions you could make to the academic, social, and personal adjustment of an incoming multicultural student: *

What part of the Mosaic Mentor Program would you change or enhance for the benefit of incoming multicultural students? *

Please upload your resume before submission of your application.

Click or drag a file to this area to upload.

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