First Name *

Last Name *

Academic Status *
- Select Option Freshman Sophomore Junior Senior Graduate

Expected Graduation Term *
- Select Semester Winter 2024 Spring/Summer 2024 Fall 2024 Winter 2025 Spring/Summer 2025 Fall 2025 Winter 2026 Spring/Summer 2026 Fall 2026 Winter 2027 Spring/Summer 2027 Fall 2027 Winter 2028 Spring/Summer 2028 Fall 2028 Winter 2029 Spring/Summer 2029 Fall 2029

Academic Major *

Academic Minor

GPA *

G-number *

Phone: *

Email *

Pronouns (ie: she/he/they)

Country
- Select Country Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentine Republic Armenia Aruba Australia Austria Azerbaijan Azores Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos Colombia Comoros Congo Cook Islands Costa Rica Cote D'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Do Not Use Do Not Use Do Not Use Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Islands Finland France French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Republic of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Island Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda S Georgia Sandwich Islands Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent The Grenadines San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovak Republic Slovenia Solomon Islands Somalia South Africa South Korea Spain Sri Lanka Sudan Suriname Svalbard Swaziland Sweden Switzerland Syria Taiwan, Rc Tajikistan Tanzania Thailand The Bahamas The Congo Togolese Republic Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States of America Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands (British) Virgin Islands (US) Wallis and Futuna Western Sahara Western Samoa Yemen Zambia Zimbabwe

Address 1

Address 2

City

State/Province
- Select State Alabama Alaska American Samoa Arizona Arkansas Armed Forces Afr/Can/EU/ME Armed Forces Americas Armed Forces Pacific Baker Island California Colorado Connecticut Delaware Federated State of Micronesia Florida Georgia Guam Hawaii Howland Island Idaho Illinois Indiana Iowa Johnston Atoll Kansas Kentucky Kingman Reef Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Midway Islands Minnesota Mississippi Missouri Montana Navassa Island Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Palmyra Atoll Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Trust Territory of Pacific Utah Vermont Virgin Islands Virginia Wake Island Washington Washington D.C. West Virginia Wisconsin Wyoming - Select Province Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon

Zip/Postal

First Name: *

Last Name: *

Relationship: *

Phone: *

Interest Areas *
General Wellness (stress, sleep, 8 dimensions of wellness)
Nutrition
Sexual Health
Violence Prevention

Please upload a copy of your class schedule. *
Please upload a file with the extension .csv, .xls, .doc, .pdf, .rtf, .docx, .xlsx, .pub, .bmp, .gif, .jpeg, .jpg, .png, .tiff, or .txt with a maximum size of 1 MB (1024 KB)

We ask WIT peer educators to commit to approximately 3-5 hours per week. Please list your other extracurricular and work responsibilities and approximate time commitments for next year.

Have you worked for GVSU before? *
- Select Option Yes No

If yes, where? *

Are you currently working for GVSU? *
- Select Option Yes No

If yes, where and how many hours do you work per week? *

Are you currently certified in CPR/AED/First Aid? *
- Select Option Yes No

Please upload your CPR/AED/First Aid Certification.
Please upload a file with the extension .doc, .pdf, .rtf, .docx, .pub, or .txt with a maximum size of 1 MB (1024 KB)

Do you have any other relevant certifications? If yes, list them here.

Have you been awarded work study? *
- Select Option Yes No

Are you an international student? *
- Select Option Yes No

How did you hear about this job? *
- Select Option Laker Job Board Website Faculty, Staff, or Campus Department Friend or Family Not listed Please specify a value for How did you hear about this job?

Why are you interested in working for Recreation & Wellness? *

Do you have a resume and/or cover letter? *
- Select Option Yes No

Please upload a copy of your resume. *
Please upload a file with the extension .csv, .xls, .doc, .pdf, .rtf, .docx, .xlsx, .pub, .bmp, .gif, .jpeg, .jpg, .png, .tiff, or .txt with a maximum size of 1 MB (1024 KB)

Please upload a copy of your cover letter.
Please upload a file with the extension .csv, .xls, .doc, .pdf, .rtf, .docx, .xlsx, .pub, .bmp, .gif, .jpeg, .jpg, .png, .tiff, or .txt with a maximum size of 1 MB (1024 KB)

Please list your last three jobs, starting with the most recent.

Employer Name

Dates Employed

Position Held

Supervisor Name

Supervisor Phone

Employer Name

Dates Employed

Position Held

Supervisor Name

Supervisor Phone

Employer Name

Dates Employed

Position Held

Supervisor Name

Supervisor Phone

Why are you interested in being a WIT peer educator? In what ways can this position help you achieve your personal and professional goals? *

Briefly describe any previous experience (academic, volunteer, personal, work-related, etc.) that might have prepared you to serve as a WIT peer educator. *

What knowledge, strengths, interests and skills will you bring to the WIT peer education team that will help make you and your team successful? *

What experiences do you have in giving presentations or facilitating group discussions? *