Alcohol, Tobacco & Other Drug Peer Educator Application

Peer education applications are accepted on a rolling basis. If you are interested in joining complete an application. If there are any openings we will let you know. Otherwise, we will add your name to the waiting list and invite you to interview when openings become available. Students are only able to participate in one peer ed group at a time.

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.

Please open the application using Google Chrome or Internet Explorer to complete.

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:

Standing Information

Current Standing:

FreshmanSophomoreJuniorSenior

Major:

Expected Graduation Date:

1. Why are you interested in becoming an alcohol and drug 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 an alcohol and drug peer educator should possess?

5. What do you hope to gain from your experiences as an alcohol and drug peer educator?

6. How did you hear about the alcohol and drug peer education program?

I hereby, declare that all of the 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: