Tusculum University-Greeneville-SSS-Mentor Recommendation

SSS Pioneering Connections Peer Mentor Faculty Recommendation Form

Potential Peer Mentor's Name: *

First NameLast Name

To the Evaluator: The student listed above is applying to be a Peer Mentor for new students at Tusculum University. If chosen, this student will serve as a mentor to 1-5 new students. Please comment on the capabilities of this individual based on your interactions. Thank you for your assistance in our selection process. (Attach a letter of reference if needed)

Name of Reference

First NameLast Name

Phone Number

(999)999-9999

Position/Title

E-mail*

example@example.com

How long have you know the applicant?

In what capacity?

Please identify the level at which the applicant has performed the qualities listed below according to the scale:

Rows	Excellent	Good	Average	Fair	Poor	No Basis for Judgement
Communication Skills
Reliability/Responsibility
Self-Confidence
Adaptability/Flexibility
Maturity
Leadership Potential
Public Speaking Skills
Cooperation with Others
Receptive to Differences

*Please list those personal characteristics you believe this candidate possesses that would be beneficial to the Peer Mentoring Program.

*Please list any personal characteristics you believe may deter this candidate from being a successful Peer Mentor.

*If desired, please attach any additional information on the applicant's abilities and potential to succeed in this position.

*Based on your knowledge of the applicant, as well as the type of position for which she/he is applying, please circle your overall recommendation of how this person will function in this position:

Recommend HighlyRecommendRecommend with ReservationsNot Recommend

Signature

Date

mm-dd-yyyy

*Once submitted, this form will go directly to the Multicultural Retention Coach within Student Support Services for review.