Student Mentor Application
A Personal Details
Surname
Forename(s)
Term Address:
Title
Home Address:
Address line 1
Address line 2
Address line 3
Town/City
Post code
Home phone number
University e-mail
Mobile number
Other e-mail
Please indicate if any of the following categories apply to you:

SCOT pupil

College Connect member

Caledonian Club pupil

Care Leaver

FOCUS West pupil

Advanced Higher Hub pupil
B Work Preference
Would you prefer to work with?
(Tick as many as you like)
Nursery:
Secondary Pupils:
Primary Pupils:
College students:
Please provide a statement supporting
each of the group(s) you have selected
above.
What secondary school did you attend?
Level (i.e. HNC)
Have you ever attended College?
(If yes, please provide details – level of
qualification, course & college)
Course
College
C Study Information
Year of study in 2016/2017? (for
example, third)
Working as a Student Mentor is designed to fit around your studies and other part-time work without fixed hours each week. However, it
would be helpful if you could outline your potential availability in SEMESTER A, if known.
Monday
Tuesday
Wednesday
Thursday
Friday
Course Name
am
pm
am
pm
am
pm
am
pm
am
pm
Student Mentor Application
D Other Relevant Details
Please outline your current or most
recent job (if applicable)
Do you have experience of support or
voluntary work? If so, please provide
details.
E
Relevant Skills, Qualities and Experiences
Please use the following section to describe what skills, qualities and experience you can bring to the role, as outlined in the post profile.
Student Mentor Application
F
References
Please provide contact details of two referees, which should include at least one from GCU or your most recent educational institution.
Name
Organisation
Address
Telephone
Email
G Declaration
I certify that the information provided on this form and in any attachments is correct. I agree that if successful, any photographs or footage
taken whilst working as a Student Mentor may be used in the promotion of Glasgow Caledonian University. The information I have given
may be stored in manual and electronic files and is subject to the provisions of the Data Protection Act 1998. I agree to information
provided on this form being used by the University in accordance with the Act and that if I am unsuccessful all documentation related to my
application will be confidentially destroyed after 6 months.
Signature:
Date:
We consider a submission by email to be a signed application.
Please ensure this document is saved in the Microsoft Office format .doc or .docx and submit your application to: [email protected]
quoting ‘Student Mentor Application’ in the email subject field. The closing date for applications is Wednesday 21 st September at 9am.
We will confirm receipt of your application and notify you if you have been invited to interview by Friday 23 rd September.