Peer Educator Application Step 1 of 7 14% Peer Educator General InformationName* First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Birthday*Cell PhoneHome PhoneDo you have Facebook?*YesNoPrimary Language*Name of School You Attend*Grade*GPA*Graduation Year* Parent/Guardian General InformationName* First Last Phone* Peer Educator Volunteer ApplicationWhy 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?* Please rate the following elements of F2B in terms of the importance to youInteracting With Others*Low ImportanceNot Really ImportantNeutralKinda ImportantHigh ImportanceMaking Friends*Low ImportanceNot Really ImportantNeutralKinda ImportantHigh ImportanceHaving Support From People With The Same Values*Low ImportanceNot Really ImportantNeutralKinda ImportantHigh ImportanceCommunity Service Hours*Low ImportanceNot Really ImportantNeutralKinda ImportantHigh ImportanceDeveloping Leadership Skills*Low ImportanceNot Really ImportantNeutralKinda ImportantHigh ImportanceLeading and Motivation Other Youth*Low ImportanceNot Really ImportantNeutralKinda ImportantHigh ImportanceF2B Socials / Workshops*Low ImportanceNot Really ImportantNeutralKinda ImportantHigh ImportanceHaving a F2B Staff Person Support Me*Low ImportanceNot Really ImportantNeutralKinda ImportantHigh ImportanceBuilding My Resume*Low ImportanceNot Really ImportantNeutralKinda ImportantHigh Importance ReferencesPlease 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 1Name* First Last Phone*Relationship*Reference 2Name* 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?CommentsThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.