Ivy Tech Community College, Central Indiana
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Sexual Assault Peer Educator Application
Please provide a letter of recommendation from a  faculty or staff member of Ivy Tech community College-Central Indiana.  your reference should be able to speak to your skills as a leader as well as your overall sense of responsibility.

Other application requirements:

  • In good standing with the college; academically, financially and disciplinary.
  • GPA minimum will be utilized in the event that spaces are full (2.5 GPA).
  • Must be enrolled for the next Fall classes at Ivy Tech Community College-Central Indiana.
  • You will be required to schedule a personal interview after application is received.

Application as a Sexual Assault Peer Educator

Please provide a letter of recommendation from a faculty or staff member of Ivy Tech Community College-Central Indiana. Your reference should be able to speak to your skills as a leader as well as your overall sense of responsibility.
Other Application Requirements:

  • In good standing with the college;: academically, financially and disciplinary.
  • GPA minimum will be utilized in the event that spaces are full (2.5 GPA).
  • Must be enrolled for Fall 2008 classes at Ivy Tech Community College-Central Indiana.
  • You will be required to schedule a personal interview after application is received.

  1. Name:

  2. Email:

  3. Phone:

  4. Gender
    Male
    Female

  5. Enrollment Status
    Part-Time
    Full-Time

  6. Major/Date of Graduation:

  7. Why do you want to be a Sexual Assault Peer Educator?

  8. What unique qualities do you possess that you would be able to contribute to the team?

  9. What did you hope to learn from your experience?

  10. Please list any extracurricular activities you are currently involved in (hobbies, clubs, sports, fraternity, sorority, etc.) Note any leadership positions held.

  11. Will you be able to commit to the time as outlined in the expectations?

  12. Name of Recommender:

  13. Relationship to you:

  14. Email:

  15. Phone Number:

  16. Permission to Review Transcript: I am giving permission for my transcript to be reviewed by the Office of Student Life and Development. I also understand that this information will be kept confidential. By clicking yes below and hitting submit, you are agreeing to this action.
    Yes

  17. Date:

    18. Form created by Form Forge. Contact acox88@ivytech.edu for assistance.