| Name (first last) |
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| Gender |
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| Next semester I will be a |
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| Major/Interest |
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| Minor (if declared) |
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| Phone (xxx-xxx-xxxx) |
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| E-mail |
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| Areas of Interest (select multiple) |
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| 1. Why are you applying to be a Peer Educator volunteer? |
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| 2. Are you willing to commit at least 5 hrs/month to volunteering? |
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| 3. What are common college student attitudes or issues you would like to see challenged? What are some ways you think we can do this? |
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| 4. Peer Educators are expected to be positive role models. Describe how you, as a Peer Educator, would be a positive role model for other students. |
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