| First Name: |
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| Last Name: |
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| Missouri S&T E-Mail Address: |
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| Student Number: |
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| Cell Phone Number (Or other number where you can be reached): |
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| Class Standing (by credit hours): |
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| What will be your hardest class next semester? |
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| How many semesters have you completed at S&T (this does not include summer semesters)? |
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| Academic Standing: |
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| Major: |
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| By clicking the checkbox, I agree to the following: |
- I agree to be assigned to a peer mentor and placed in a mentor group for the duration of the semester.
- I will engage in the program through attending seminars, one-on-one or group meetings, and other supplemental activities agreed upon by me and my mentor.
- I will commit 12-15 total hours over the course of the semester to the On-Track program.
- Insufficient participation can lead to removal from the program, so make sure that you block off On-Track time commitments as soon as I receive the dates or they are posted on the registration page.
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