SM Form | UConn First Summer

2022 UCFS Student Mentor Information

Full name:*
Preferred first name:*
For your name tag, etc.
What are your pronouns?
Personal Information
Favorite chocolate/candy:*
We will provide you the opportunity to facilitate a workshop. We have some ideas for these workshops (student involvement, time management, Q/As, leadership style/skill development, identity and affinity in college, etc.), but we would be curious to see if you have any ideas as well. Please share some workshop ideas/topics you may have below.
Staff bio for website:*
We were hoping to put our summer staff biographies on the First Summer website before the program starts, and would like for you to write 4-5 sentences to introduce yourself to the incoming program students. You can be as creative as you want, but we ask that you include your current school and year, major, fun fact about yourself, things you like to do, and a photo. We also ask for you to include your position (student mentor). Here's an example: My name is Danielle Smith, and I will be a Student Mentor this summer. I am a rising senior at UConn pursuing a degree in Elementary Education with a concentration in English. I love to dance and was a member of the Dance Team for two years. I also love traveling. My favorite experience I have had at UConn was presenting my capstone research project this past fall. A fun fact about me is that I have a pet squirrel! I am so excited to be a part of the First Summer staff this year and can't wait for this summer!
Photo/headshot for website:*
Max. file size: 100 MB.
This doesn't have to be a 'professional' picture, but it should be appropriate.
Do you have any medical conditions that you would like us to know about? Do you require any accommodations?
Please list any allergies or dietary restrictions.
Emergency contact information:
Include their name, relationship to you, and phone number.
Are your CPR certified?*
- Yes
- No
CPR Information
What kind of certification is it?*

First Aid/AED/CPR, etc.
CPR Certificate # or Link:*
CPR Expiration Date:*
Car Information
Will you have a car on campus this summer?*
- Yes
- No
Do you already have a UConn parking permit for the 2021-2022 academic year?*
- Yes
- No
Car Year:*
Car Model (Fusion, etc.):*
Car Color:*
State:*
License Plate:*
Is there anything else you'd like us to know to help make this a great summer for you and for participants?
Comments
This field is for validation purposes and should be left unchanged.

2022 UCFS Student Mentor Information

Personal Information

CPR Information

Car Information