FastStart Altoona

Student Mentor Application

Please fill out the form completely. If you have any questions or problems, please contact the office of Institutional Equity and Diversity at 814-949-5053.

First Name:
Middle Name:
Last Name:
Preferred Name:
PSU ID:
Application Submitted: Fall Spring
Year:
T-shirt Size:
Date of Birth:
Sex/Gender:
Ethnicity (optional):
Permanent Address:
City: State: Zip Code:
Local Address:
City: State: Zip Code:
Email Address:
Campus/Local Phone:
Cell Phone (Optional):
Home Phone:
Intended Major:
Classification: Freshman
Sophomore
Junior
Senior
Last School Attended:
GPA:
Do you plan on working? Yes, Full Time
Yes, Part Time
Maybe
No
If yes, where? On Campus
Off Campus

Favorite Books:

Favorite Television Shows/Movies:

Favorite Foods:

Hobbies:

Music Interests (Genre or favorite artists):

Sports Interests (indicate whether you watch or play):

What else do you do in your spare time?

What are your short term goals?

What are your long term goals?

What are your academic strengths?

In which areas would you like to see improvement?

What organizations are you involved in on campus?

What organizations would you like to be involved in on campus?

What would you like to gain from participating in the FastStart program?

Security Code: 87850