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COLLEGE MENTOR APPLICATION
Tell us about yourself
Please fill out the following form to apply to be a college mentor for the Code to Success Program!
First Name
Last Name
Email
Phone
Street Address
City
State
Zip Code
Country
What college or university are you attending/attended?
What year are you in your studies?
Select option...
Freshman
Sophomore
Junior
Senior
Recently graduated
What degree are you pursuing?
Select option...
Associates
Technical Certificate
Bachelor
Masters
Other
Have you participated in any of the following Code to Success programs? and what year?
Select program...
Code to Success: Utah
Code to Success: Detroit
Idaho Codes
Utah State University Codes
Weber State Codes
Snow College Codes
Not Applicable
Select year...
2016
2017
2018
2019
2020
Not Applicable
Which coding languages are you comfortable with?
CSS
HTML
JavaScript
Other
If 'Other' was selected, what language[s] do you have experience with?
How did you hear about the College Mentor position?
Select option...
Teacher
CTE Counselor
Peers
Other
What skills and strengths would you bring to the position?
Why should we choose you for the position?
Are you applying for an On-Line position or an On-Campus position?
Select position type...
On-Line
On-Campus
If hired for an On-Campus position, would you be absent more than three times?
Select option...
No
Yes
Maybe
If applying for an On-Campus position, what are your top two campus choices?
Campus Option 1...
Advance Learning Center
Ben Lomond High School
Bountiful High School
Boys & Girls Club - Detroit
Bridgerland Technical College - Logan
Bridgerland Technical College - Brigham City
Cedar Valley High School
Cottonwood High School
Granger High School
Jordan High School
Olympus High School
Orem High School
Park City High School
San Juan High School
Skyridge High School
Timpview High School
Tooele Community Learning Center
Weber Innovation
Whitehorse High School
Lincoln Academy
Middleton High School - Idaho
Campus Option 2...
Advance Learning Center
Ben Lomond High School
Bountiful High School
Boys & Girls Club - Detroit
Bridgerland Technical College - Logan
Bridgerland Technical College - Brigham City
Cedar Valley High School
Cottonwood High School
Granger High School
Jordan High School
Olympus High School
Orem High School
Park City High School
San Juan High School
Skyridge High School
Timpview High School
Tooele Community Learning Center
Weber Innovation
Whitehorse High School
Lincoln Academy
Middleton High School - Idaho
For the program, do you prefer to work 10 or 20 hours a week?
Select option...
10 hours
20 hours
Either
What is a fun fact about yourself?
Shirt Size (adult sizes - not fitted)
Select size...
XS
S
M
L
XL
XXL
XXXL
Gender Identification
Select gender...
Identify as Female
Identify as Male
Prefer not to say
Submit