5050 Peer Helper Application
*Name:
Class Year:
Freshman
Sophomore
Junior
Senior
*Major:
Minor:
*Local Address:
*Home Town:
*LVC Email:
*Phone:
*List your curricular/co-curricular activities and group memberships:
*1-2 Professional References (past boss, supervisor, or LVC faculty member):
*Are you trained in any of the following:
Title IX
QPR Suicide Prevention Training
CREW Bystander Intervention
Brave Zone Training
Submit a personal essay (non longer than 1 page) stating your interest in becoming a 5050 Peer Helper.
Also include a one-page professional resume.
