PEERS Educator Application

Instructions: Thank you for your interest in PEERS! Please complete each section, including all 3 pages. Incomplete applications or applications where instructions were not followed will not be reviewed.

What do PEERS Educators do? PEERS Educators:

  • Organize, develop, and market educational programs and activities for fellow college students. These programs and activities are designed to provide accurate information on alcohol and other drugs, sexual health, nutrition, stress management, sun care, and other wellness issues.
  • Present health education programs to the USFSP community (Residence Halls, classes, student organizations, etc.)
  • Gain skills in communication, organization, time management, program development and outreach, evaluation techniques, the use of audiovisual equipment, and presentation/teaching methods.
  • Attend mandatory staff meetings and training events

PERSONAL INFORMATION

Name:Click here to enter text.Telephone: Click here to enter text.

Student ID:Click here to enter text.Email: Click here to enter text.

Address:Click here to enter text.

ACADEMIC INFORMATION

Major: Click here to enter text.Year in College: Choose an item.

Expected Graduation Date: Click here to enter text.Current GPA: Click here to enter text.

Please indicate type of involvement you are interested in by checking the appropriate box:

☐ PEERS General Member (helps with set-up and take-down of events, attends meetings)

☐ PEERS Leader (involves one week-training, creation and co-facilitation of events, certification)

Please see for more information about our membership levels!

Please rank the following areas according to YOUR interest (1 is highest interest, 5 least interest). Please use all options).

  1. Choose an item.
  2. Choose an item.
  3. Choose an item.
  4. Choose an item.
  5. Choose an item.

Please type your answers to the following questions in the space provided.Please use no more than 200 words per answer.

  1. How did you hear about the Peer Educator position? Why do you want to be a PEERS Educator? (What qualities or experiences do you have that would be an asset as a PEERS Member or Leader?)
  1. What do you do that demonstrates personal commitment in trying to maintain a healthy lifestyle?
  1. What other college or community-level activities, organizations, or athletic groups are involved in?How many hours do you anticipate being available to be a PEERS Educator?
  1. Tell us about an achievement or involvement with a campus or high school group, of which you are proud.
  1. What else would you like us to know about you?

***APPLICATION DEADLINE FOR PEERS MEMBERS: September 18, 2015***

***APPLICATION DEADLINE FOR PEERS LEADERS: March 31, 2016***

For more information, email Victoria Beltran, MPH, CHES at or call 727-873-4377.

Please return completed applications to the Wellness Center (SLC2200) or email ( or ).

Updated September 2015Go to Next Page  Page1of3

PEERS Educator Application

Student Schedules

Name:Click here to enter text.Semester:Choose an item.

Please mark all the time slots that you are NOT available (because of classes, work, etc.) with an X.

Hours / Monday / Tuesday / Wednesday / Thursday / Friday
8:00 – 9:00 / ☐ / ☐ / ☐ / ☐ / ☐ /
9:00 – 10:00 / ☐ / ☐ / ☐ / ☐ / ☐ /
10:00 – 11:00 / ☐ / ☐ / ☐ / ☐ / ☐ /
11:00 – 12:00 / ☐ / ☐ / ☐ / ☐ / ☐ /
12:00 – 1:00 / ☐ / ☐ / ☐ / ☐ / ☐ /
1:00 – 2:00 / ☐ / ☐ / ☐ / ☐ / ☐ /
2:00 – 3:00 / ☐ / ☐ / ☐ / ☐ / ☐ /
3:00 – 4:00 / ☐ / ☐ / ☐ / ☐ / ☐ /
4:00 – 5:00 / ☐ / ☐ / ☐ / ☐ / ☐ /
5:00 – 6:00 / ☐ / ☐ / ☐ / ☐ / ☐ /
6:00 – 7:00 / ☐ / ☐ / ☐ / ☐ / ☐ /

***APPLICATION DEADLINE FOR PEERS MEMBERS: September 8, 2015***

***APPLICATION DEADLINE FOR PEERS LEADERS: March 31, 2016***

For more information, email Victoria Beltran, MPH, CHES at or call 727-873-4377.

Please return completed applications to the Wellness Center (SLC2200) or email ( or ).

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