The University of Toledo :

Welcome

R2R Home
GET INVOLVED

· Peer Mentor Commitment Form

· Faculty/Staff Commitment Form

· Questions
Program Overview

· Objectives

· Pillars

· Outcomes

· Pilot Program
Program Administration

· Steering Committee

· Launch Teams

· College Liaisons

· Partner Liaisons
Announcements

· General Announcement Letter

· Upcoming Training Dates
Resources
Contact Us

ROCKET-2-ROCKET PEER MENTORSHIP PROGRAM

Faculty/Staff Mentor Commitment Form

INSTRUCTIONS: Please provide information and answer questions as requested. Be sure to read and agree to the Faculty/Staff commitments by checking the appropriate boxes at the bottom of the form. Questions about the peer mentorship program should be directed to either Michele Martinez (ext. 5323) or Jeff Witt (ext. 3701).

Name and Title:

Rocket #:

Department:

Direct Supervisor:

List any Co-Curricular Involvement at UT (if none, leave blank):

E-Mail Address:

Phone Number:

Local Mailing Address:

Summer 2009 Phone Number (If different than above):

Summer 2009 Mailing Address (If different than above):

PLEASE READ AND AGREE WITH THE FOLLOWING FACULTY/STAFF MENTOR COMMITMENTS BY CHECKING THE BOXES BELOW (scroll over [?] for further information):

Commit to Student Centeredness [?]

Attend the R2R Kick-Off Party (optional) [?]

Notify R2R Staff of Changes in Contact Information [?]

Serve as a Faculty/Staff Mentor to UG Students [?]

Communicate Monthly with Mentees [?]

Join/Check the Peer Mentorship Facebook Page [?]

Complete a Rocket-2-Rocket briefing [?]

Attend the R2R End-of-Year Recognition Ceremony [?]

Please be sure you have filled out the form completely and accurately before submitting.

Page updated: April 27, 2009

Page top

Office of Dean of Students :