We hope that you will answer all of the questions completely and honestly. THE INFORMATION YOU PROVIDE WILL ONLY BE REVIEWED BY CHEW's PROFESSIONAL STAFF.
Name
Local/campus phone #
Home phone#
Local/Campus address
E-Mail address
Major
Minor
Current year in school classification
Please select... Freshman Sophomore Junior Senior Grad
Anticipated month and year of graduation (mm/yy)
Will you be at the University for Summer Session this year? Yes No
How many credits will you take in the coming Fall semester?
Spring semester?
What is your current GPA in your major field?
Overall?
If you have a job, how many hours will you be working next year?
Please list any extracurricular activities you are planning to participate in next year:
What other activities have you been involved in at the University?
What committees of the Coalition of Peer Educators are you interest in (check all that apply)?
Please respond to the following questions and statements:
1.
Why is becoming a peer educator important to you?
2.
How is wellness an aspect of your everyday life?
3.
Describe any experience you have speaking in front of groups or your peers?
4.
What do you believe will compel other students to make healthier, more responsible decisions?
5.
What are two program ideas you have for the areas of COPE you are interested in?
6.
Why are wellness and healthy lifestyle habits important aspects of a college student’s life?
7.
How would your academic major contribute to the COPE organization?
