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Counseling Center

Body Image Peer Educator Peer Application

Please complete this application and click the "Submit Form" button to forward it to the Counseling Center. If you have any questions, please contact the Counseling Center at (410)-704-2512.

Contact Information for Peer Education Application:

First Name:
Last Name:
Middle Initial:
E-Mail:
Cell Phone:
Local Phone:
Local Address:
City, State, Zip:
Home Phone:
TU ID#:
Date of Birth:

Current Standing:

Freshman
Sophomore
Junior
Senior

Major:
Expected Graduation Date:

1. Why are you interested in becoming a peer educator?

2. Please list and describe any relevant courses, training, volunteer and/or work experience.

3. Please list any campus/community organizations in which you are involved.

4. What do you think are the most important qualities and skills that a peer educator should possess?

5. What do you hope to gain from your experiences as a peer educator?

6. How did you hear about the peer educator program?

7.What makes you interested in becoming a Body Image Peer Educator specifically?

8. Most individuals in this culture struggle with feeling good about their bodies and having a healthy, flexible relationship with food. Can you discuss a time in which you felt challenged or struggled with one of these issues and how you handled the situation?

9. Some students may become interested in becoming a Body Image Peer Educator because they themselves have struggled with eating disorders. While those who have recovered from body image or eating issues are welcome in the program, students must be in a place of sustained recovery to be a part of the program. What is your reaction to this question?

10. If you became part of the program and began experiencing body image or eating issues, how might you handle it?

All information provided on this application form is true to the best of my knowledge.

Online Signature (Typing your name is equivalent to an online signature.)

Date:


 

 

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