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50 Years of Section 504
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OMED: Educational Services
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Apply to be a Challenge Counselor
OMED: Educational Services
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First Name
Last Name
Email Address
Street Address
City, State & Zip Code
GT Dorm (if applicable)
Cell Phone
Emergency Contact Name
Emergency Contact Phone
GTID
Classification
Freshman
Sophomore
Junior
Senior
Master's
Doctorate
Major
Last Semester GPA
Cumulative GPA
Expected Graduation Date
Expected Graduation Date: Month
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Expected Graduation Date: Year
Year
2050
2049
2048
2047
2046
2045
2044
2043
2042
2041
2040
2039
2038
2037
2036
2035
2034
2033
2032
2031
2030
2029
2028
2027
2026
2025
2024
2023
2022
Summer Plans
Taking Classes (no more than 6 hours)
Internship/Co-op (not applicable to be a counselor)
On-campus Research (working w/professor)-less than 6 hours
Study Abroad (not applicable to be a counselor)
Not Taking Classes Summer Semester
Please list any summer plans you have in addition to being a Challenge Counselor.
How many credits are you planning to take next semester?
Cannot be enrolled in more than 6 hours while serving as a Challenge counselor
Please list any academic skills, technical skills, training, certification, etc. that you have obtained which may be beneficial in this position.
Please list any social/community activities or organizations that you have participated in. Also denote if you served in leadership positions.
Describe any prior campus employment: Dates, Position, & Supervisor
Describe any internship, co-op, or other work: Dates, Company, Position, Supervisor
Are you eligible for Federal Work Study? If unsure, please contact Fin Aid 4-9369.
Yes
No
Why are you interested in this position?
What qualities and/or experiences do you have that will make you a good mentor/tutor for new students?
Describe one or more times when you worked with a diverse population.
What do you believe are the keys to academic success at Georgia Tech?
Feel free to write about anything that you wish to explain about your application or anything additional that you would like to tell us about you.
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