Provost Scholars Mentor Application

Provost Scholars Mentor Application

Thank you so much for your interest in being (or continuing to be) a Provost Scholar Mentor!

The Provost Scholars Program is a partnership between Case Western Reserve University (CWRU), Ginn Academy (CMSD), Cleveland School of the Arts (CMSD), and East Cleveland City Schools. The program matches high school Provost Scholars with Case faculty and staff mentors to improve the Scholars’ academic and career outcomes.

Please take a moment to provide us with the information we will use to pair you with a Provost Scholar! If you have already been paired with a scholar, please use this form to confirm you still intend to continue your work with them this year.

If you have any questions or concerns, please do not hesitate to contact me!

With gratitude,

Latonya Shazor, Provost Scholars Program Coordinator
216-512-1747 (office/mobile) | Latonya.Shazor@case.edu
Full Name *


Title and Position *


College/School/Department *


Office Location and Number


Best contact phone number *


Alternative Phone Number:


Have you served as a Provost Scholar Mentor before?

Comments:



If you answered yes to the last question, would you still be interested in working with the same mentee this year?

Comments:



Career or Professional Area of Expertise (check all that apply):

Comments:



What are some of your hobbies?


Please list three of your personal interests including academic subjects, extracurricular activities, and research:


Have you worked with, taught or mentored middle-school or high school students before? Please explain:


Have you worked with, taught or mentored individuals from underserved communities before? Please explain:


How can you help your mentee's growth in these three dimensions: academics, personal goals and career advancement?


During the academic year, mentors are expected to spend Tuesdays from 3:00 PM - 4:45 PM with their mentee. Start times may vary depending on the Scholar's school dismissal time. Is this timeframe workable for your schedule? *

Comments:



Please provide a link to a faculty page with your photo and biographical information.
Additional instructions for the previous question. We include mentor photos and biographies in program materials, including annual reports.


We are always looking for good mentors for our scholars. Do you have a colleague you recommend? Please their name and department and we will reach out to them.


Questions for us?


I understand that part of being a Provost Scholars Mentor involves submitting to a FBI/BCI background check (fingerprinting) every three (3) years which the university will provide at no personal cost to me. I also promise to follow the university's compliance protocols and best practices for youth program participation. I will report any situations that would fall under the purview of my role as a mandated reporter. *



Thank you so much for completing the mentor appliction.  We are grateful for your investment in these talented and promising young Scholars.