How Did You Learn About This Position: ______

Wellness Ambassador Program

2016-17Volunteer Application

Student Health and Counseling Services

Name: ______

Address: ______

Phone: (___)______Student ID #: ______

Email:

How did you learn about this position: ______

Academic and Leadership Information:

Student Status (please circle your year): 1st 2nd 3rd 4th 5th +

Major: ______Minor (if applicable): ______

Current GPA: ______Expected Graduation Date: ______

Please list current and/or past leadership positions. You may include on and off campus experience.

Position: ______Organization: ______

Where did you hear about the Wellness Ambassador Program? ______

Have you attended any Wellness Ambassador events? If so, please list below:

______

1. Why are you interested in this position and what do you hope to gain from it?

2. What qualifications or skills do you have that will benefit the Wellness

Ambassador Program?

3. Please list any jobs, volunteer work, participation in student organizations,

and/course experience you have related to the position. You can supplement

this answer by attaching a résumé.

4. Please describe any public speaking experience or training you have received.

5. Please explain any training and/or experience you have had related to peer

advocacy.

6. Please list the time commitments you will have next year (e.g. academic

responsibilities, student organization involvement, and other work and/or

athletic responsibilities).

The following commitments are required for this position. Please initial each to confirm that you can meet the following requirements:

_____ Will be a current student during all three quarters, in satisfactory standing,

Fall 2016 continuing through Spring 2017.

_____ This position is a three-quarter commitment, in addition to training classes

during Spring 2016quarter.

_____ Work up to 6 hours per week during Fall, Winter and Spring quarters. (2-

3 hours of which are between the hours of 9 am – 4 pm).

_____ Attend weekly program meetings on Thursdays from 5 – 7 pm.

_____ Attend weekly volunteer meetings TBA

Please list two references (No friends, roommates or family member please).

NamePhoneRelationship

1)______

2) ______

I hereby certify that all information I have provided in this application is true. I understand that by submitting this form any information will be reviewed by Student Health and Counseling Services staff to determine whether I qualify for this position. In addition, I have read the requirements and understand what is expected of me as a Wellness Ambassador Volunteer.

Signature: ______Date:______

Applications are due by 5:00 PM on Tuesday, February 16, 2016 to the Student Health and Counseling Services,

North Hall 2nd Floor – Room 227.

Or via email at.

**No late applications will be accepted**