I. Basic Information

Local Address:
Street:
City:, CA  Zip:
Local Phone:xxx-xxx-xxxx
Cell Phone:xxx-xxx-xxxx

Major: Choose From List Anthropology Anthropology/Law&Society Art (Studio) Art History Asian Studies Asian American Studies Biochemistry Biological Sciences Biology Biomedical Sciences Black Studies Botany & Plant Sciences Business Administration Business Economics Chemical Engineering Chemistry Chicano Studies Chinese Classical Studies Comparative Ancient Civilizations Comperative Literature Computer Engineering Computer Science Conservation Biology Creative Writing Dance Economics Economics/Administrative Studies Economics/Law and Society Electrical Engineering Environmental Engineering English Entomology Environmental Sciences Ethnic Studies Film & Visual Culture French Geology Geophysics German History History/Administrative Studies History/Law and Society Human Development Humanities, Arts, & Social Sciences Language Latin American Studies Law & Society Lesbian, Gay, Bisexual Studies Liberal Studies Linguistics Mathematics Mechanical Engineering Music Native American Studies Neuroscience Philosophy Philosophy/Law and Society Physics Political Science Political Science/Administrative Studies Political Science/Law and Society Political Science/Public Service Psychology Religious Studies Russian Studies Social Relations Sociology Sociology/Administrative Studies Sociology/Law and Society Spanish Statistics Theatre Women's Studies Undeclared - Natural & Agricultural Sciences Undeclared - Humanities, Arts & Social Sciences Undecided Cumulative GPA:
Are you a US Citizen?          yes no

II. Additional Information

References:  Please give us the names and phone numbers (or email) for two references. 
At least one reference must be from on campus (excluding your UHP Peer Mentor)

Extracurricular Involvement
In order for us to have a better understanding of your commitments please indicate
all of the activities in which you are currently involved by listing them in the appropriate spaces below.

Summer University Honors Program Interest
Are you interested in working SUHP?
 yes  no

Current Peer Mentors can skip the next segment and submit the application at this point.

III. Short Essay

Often, Peer Mentors comment that being a mentor is a life changing experience.  As a peer mentor, what changes do you hope or expect to see?
250-500 words in the field below. (you should cut & paste from a word processor)

New Peer Mentor applicants must complete this section!