Mentor Recommendation form

The applicant listed below is applying to be staff (a Mentor) in Pitzer College/WesternU’s Native Youth to College Summer Program for Native high school students offered by Pitzer College/Western University of Health Sciences.

Please fill out all questions and email to

Step 1 of 2

  • Nominator's Information

    Please place your information in this section.
  • Please enter a value between 0 and 50.
  • Nominee / Mentor Applicant's information

    *If you would like to receive more information about Pitzer/WesternU's Native Youth to College Summer Program, please email

    Please comment on the applicant’s overall ability in the following areas, taking into specific consideration their leadership qualifications, commitment and maturity. This reference will remain confidential and will be used solely to assist in decisions regarding the admissibility of the applicant as a mentor for the program.

  • Please Rate

    Please rate this applicant as objectively as possible in comparison with ALL the students you have taught/mentored.
Page last updated on July 31, 2017