Please print out and complete this application form. One letter of recommendation from a supervisor, professor, or mentor is necessary to complete your application.
Date: ____________
Name: ___________________________________________________
Address: ________________________________ City: ________________ State: ____ Zip: _______
Current Phone: _____________________________
Phone where you can be reached this summer: _____________________________
Email: ___________________________________________________________________
Current Year in School: Fresh. ____ Soph. ____ Jr. ____ Sr. ____ Grad. Student ____
Major: ___________________________________ Minor: ___________________________________
If necessary, attach an additional page for responses to the following items.
1. Why do you want to become a Wellness Advocate?
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2. Provide a brief description of relevant health education-related experience(s).
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3. Provide a brief description of a time in your life when you demonstrated leadership (in
high school, college, on an athletic team, in a community or church group, etc.)
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4. What role(s) do you tend to take on in a group?
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5. In your opinion, why is a college peer health education program of value?
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6. In what other student or community organizations do you actively participate?
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One letter of recommendation from a supervisor, professor, or mentor is necessary to complete your application.
Application Deadline:
All application materials, including recommendation letter, must be received by this deadline.
Upon turning in your application, please stop by the Wellness Center Resource Room to sign up for an interview. Deadline: April 4, 5 PM. Interviews will be held April 7-10.
Please return this application and a letter of recommendation to:
Alissa Eischens, Wellness Center, 1052 Loyola Ave, Chicago, IL 60626. Fax: 773-508-2740.
Need more information? Visit http://www.luc.edu/wellness/advocates.shtml or contact Alissa Eischens at 773-508-2751 or aeische@luc.edu.