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Student Application

Office of Diversity, Equity and Inclusion

Home > Office of Diversity, Equity, and Inclusion > Strive Mentorship > Student Application

STRIVE Mentorship Program Student Application

- Step 1 of 3

Demographic information

Name *

First

Middle

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Date of birth *

Marital status *

Preferred method of contact *

phone
email

Ethnicity *

Gender identity *

Preferred gender pronoun *

Is English your first language? *

yes
no

If no, please specify *

Have you served in the Armed Forces? *

yes
no

Emergency contact details

Name *

First

Middle

Last

Relationship *

Phone *

Mentorship information

Semester and year you wish to participate? *

Fall
Winter

Have you been mentored previously? *

yes
no

Have you previously applied to the STRIVE Mentorship program? *

yes
no

Have you participated in the StreetWise Partners Mentorship or any other skills training program previously? *

yes
no

If yes, please specify *

Do you have access to a device to conduct virtual meetings? *

yes
no

Do you have reliable access to the internet? *

yes
no

Academic information

Complete the following or attach a copy of your transcript (obtain a copy via the SC4 Registrar's office)

Have you applied for any scholarships? *

yes
no

What scholarships? *

Major *

What year are you currently in? *

GPA *

Advisor *

Anticipated graduation date *

Are you a student athlete? *

yes
no

Do you have a documented disability? *

yes
no

Are you the first in your family to attend college? *

yes
no

What level of college degree are you pursuing? *

What is the highest level of education completed? (please indicate U.S. or foreign) *

Career information and goals

Are you currently working? *

yes
no

If yes, are you working... *

Employer name *

Job title *

Are you currently looking for work or an internship? *

yes
no

What shift are you looking for? *

part-time
full-time
per diem
temporary
internship

Select the industry area(s) of interest: *

Construction & energy
Criminal justice
Engineering
Finance
Healthcare
Leisure & hospitality
Manufacturing
Mathematics
Retail trade
Teaching/Education
Technology
Transportation, distribution & logistics
Other

If other, please list *

Additional questions

What is your preferred communication style? *

Direct and to the point: Someone who will push you and be honest.
Honest with a soft approach: Someone who will be honest and supportive at the same time. Lead you in the right direction and give a soft push, but not push too hard.
Coaching: Someone who has a collaborative approach to feedback and will explore all avenues until you both agree.

What focus area do you feel you need the most support? *

Interviewing: discuss and practice interview techniques
Networking: How to sell yourself, how to form and maintain relationships
Job search skills: Where to look and how to apply for a job, how to follow-up on your resume or application
Professional communication: Verbal and written communication skills including email etiquette
Public speaking: Becoming more confident speaking in front of a group
Resume writing: What to include, formatting and language
Project management: Meeting deadlines, setting a schedule and making productive use of your time

Choose up to four areas.

Will you need to miss any sessions? *

yes
no

Why? *

Electronic signature *

Type your full legal name in the box provided as an electronic signature for this Application for STRIVE Mentorship Program Application.

Date *

Motivation Success Coaching Goal and direction illustration with gears

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St. Clair County Community College

323 Erie St. | P.O. Box 5015
Port Huron, MI 48061-5015
(810) 984-3881 | enrollment@sc4.edu

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