Mentoring Support Authorization

Congratulations on maintaining eligibility for the Nevada Promise Scholarship at the College of Southern Nevada (CSN). You are ready to take the next step to meet with an assigned mentor who will support you throughout your college experience.

Instructions:

  • Applicants must complete the “Parent/Guardian Authorization for Mentoring Support” form electronically. Once the form is submitted, applicants will view a completion screen confirming successful submission, as well as receive an email confirmation.
    • For your records, please save a record of both notifications by taking a screenshot of the completion screen and save the confirmation email as a pdf. This protects the applicant in the event that the Nevada Promise Office requests documented proof of submission.
  • This form requires the signature of the student (regardless of age) and the parent/legal guardian (if the applicant is a minor). See more details below.
  • Once received by the Nevada Promise Office, Applicants will be matched virtually with a mentor. The Applicant will receive an email with their mentor’s name, contact information and instructions on how to connect virtually.
STUDENT INFORMATION
Please enter your 5 - 10 digit High School Student ID#
Please enter your 10 digit CSN NSHE ID#
QUESTIONS

I have reviewed and agree with the information provided below (check all boxes to complete application):

I will receive contact information for my assigned mentor. I understand that the purpose of the contact information exchange is for establishing mentoring meetings and for mentoring purposes only. Mentor-Mentee Assignments will be communicated via email starting in March
Prior to my enrollment at CSN, I will provide Directory Information (contact information) to my assigned CSN Promise Scholarship Mentor. There may be a possibility that not enough mentors have signed up and completed the process by the deadline. Mentor pairing will be provided on a first-come first-served basis. It is important to complete the requirements as soon as possible. I understand that it is my responsibility to engage with my assigned mentor during the Nevada Promise Scholarship Program.
Once enrolled, students can manage third party access to their student records via MyCSN. For information about Family Education Rights & Privacy Act (FERPA) https://www2.ed.gov/policy/gen/guid/fpco/ferpa/index.html.
I understand that CSN offers opportunities to engage with my mentor on campus, during pre-set dates for mentoring meetings in public spaces throughout the main campuses. I must visit the www.csn.edu/promise website for more information about the mentoring requirement. As the mentoring relationship progresses, and by mutual consent of the mentor and myself, the mentee, online or phone communications are are permissible.
I am encouraged to attend my mentor meetings with a guardian or family member.
I have taken the mandatory training for mentees about maintaining appropriate mentoring relationships available in the CSN Nevada Promise website, www.csn.edu/promise/mentoring-requirement.
I certify and acknowledge the information on this form is correct and complete.
AGREEMENT

Acknowledgement and Verification of Parent/Guardian Authorization Form
I acknowledge that the Nevada Promise Scholarship requires the Parent/Guardian Authorization Form to be submitted before I receive mentor matching information according to the guidelines as stated on the www.csn.edu/promise webpage. I understand I am required to complete the form and sign as both student and parent to document that I am 18 years of age at the time of completing this form. I hereby certify that I reviewed and agree with the information provided.  I acknowledge that I am required to keep a copy of the confirmation of verification that will be issued once I submit this form. I also acknowledge that I may be required by the CSN Promise Team to present documentation to verify the form was submitted and that failure to produce such documentation may disqualify me from receiving the Nevada Promise Scholarship. Having read and understood this certification, I submit this CSN Promise Parent/Guardian Authorization Form electronically by clicking the submit button below.

Please enter your full name.

Parent or Legal Guardian: Your signature verifies you are a parent or legal guardian of the above student and are aware the student has applied to the Nevada Promise Scholarship at CSN and is required to meet with a specially screened mentor to qualify. Contact information will be exchanged as part of the process. Your signature below certifies you have read and understand this form: 

Please enter your full name.