Group(s) for which you are applying:
ADAPT/PAWS PASS

Local Address:

Permanent Address:

Email address:

Cell phone:

Permanent phone:

Year in school:

Current GPA:

Major:

Date of birth:

Personal references: Two (2) faculty/staff (include name, department, phone number and email address) and at least one (1) student (include name, phone number and email address). **For first semester freshman, references from high school teachers is acceptable although any references from MU would be ideal.

Please list your work experiences, volunteer activities, and campus involvement (note those activities in which you are currently involved). List your most recent involvement first and include dates of service and duties performed.

Why are you applying to be a Wellness Peer Educator?

What strengths do you think you have that may enhance our program?

List courses you have taken which deal with issues of wellness (nutrition, nursing, biology, etc.)

Describe any experiences you have had involving public speaking.

What do you expect to gain from the experience of being a Wellness Peer Educator?