Free To Be Forms

Peer Educator Application

Step 1 of 7

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Peer Educator General Information
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Birthday*
Cell Phone
Home Phone
Do you have Facebook?*
- Yes
- No
Primary Language*
Name of School You Attend*
Grade*
GPA*
Graduation Year*

Parent/Guardian General Information
Name*
First Last
Phone*

Peer Educator Volunteer Application
Why are you personally committed to avoiding risk behaviors, including postponing sexual activity until marriage?*
Why do you think it is important to speak to students about these choices?*
Please tell us about yourself.*
Please share with us one unique or special thing about you.*
Do you have prior experience doing volunteer work/community service with another organization? If so, what did you do and with whom?*

Why are you applying to become a Free to Be Peer Educator?*
What skills, talents and experience do you have that you feel prepares you to be a Free to Be Peer Educator? Please explain why?*
How would Free to Be benefit from your involvement? Please be specific.*
What is the coolest thing you’ve ever done?*
What do you hope to gain personally from your involvement with F2B?*

References
Please list two adults (non-family members), one of which must be a teacher, whom we may contact (i.e. family friend, counselor, youth group leader, coach, etc.) to ensure that you are a match for our program.
Reference 1
Name*
First Last
Phone*
Relationship*
Reference 2
Name*
First Last
Phone*
Relationship*

What other commitments do you have this school year and how will F2B fit into your schedule?
What else would you like to share with us about yourself?
Comments
This field is for validation purposes and should be left unchanged.