APPLICATION TO BECOME A POW! VOLUNTEER

IMPORTANT NOTE: If you have not picked up a hard copy of the application packet from the Wellspring office, and you are therefore completing this process entirely online, it is imperative that you first read the four webpages provided on this website entitled Expectations, Responsibilities, Application Information, and Training Information. These pages outline the application process, important dates and deadlines, required training, and other expectations of applicants.

Please complete and submit this application (you must click on the submit button at the bottom and receive a response email which you may print for your records in order to complete the application process) or submit a hard copy application to the Wellspring Office at 231 South College Avenue -- the white house next to the Morris Library, behind the brick wall in the gold parking lot. It would be of great assistance to us to have you answer the information requested here thoroughly and submit the application promptly. We thank you for your interest in our group and look forward to talking with you.

Name:

Year In School:

Major:

If you are a senior, will you be attending the UD for an extra semester?

Yes No

Current/Campus Address:

Phone:

E-Mail Address:

Age:

Sex: Male Female

Please list any other groups or clubs you are involved with.

Are you an R.A.?

Yes No

1. Please list and describe any relevant courses, training, work experiences, programming experience, or related interests which you think would contribute to your involvement as a Wellspring Peer Educator/Pow! Member.

2. What are the major reasons you are interested in becoming a health peer educator? What are your personal goals for volunteering with this group?

3. Other than what is listed in question #1 above, what unique qualifications do you think that you as an individual could bring to the position of peer educator? Please be specific.

4. Being a peer educator does involve an on-going time and energy commitment (training, continuing in-service training, meetings, programming, etc.). How does this expectation fit in with your priorities and time commitments in the foreseeable future?

5. What do you think are currently the most pressing student concerns on campus relating to health/wellness issues? What needs for information, resources, etc. about health and wellness do you think are most lacking and what do students have the most misinformation about?

6. If you were selected to be a Wellspring Peer Ed, what Wellness Issues do you think would most interest you (please mark with a "*")? Which topics do you think you would be most comfortable talking to your peers about (please mark with an "x")?

NOTE: IF YOU STARRED OR "X"ed THE CATEGORY OF EATING DISORDERS IN QUESTION #6 ABOVE, PLEASE ANSWER THE FOLLOWING TWO QUESTIONS:

7. As best as possible, please describe the dynamics that you think play a part in causing an individual to develop disordered eating patterns.

8. Are you satisfied with your current state of health regarding your relationship to food? Please explain.

9. Please list the name and phone number or e-mail address of two character references.

1.

2.

10. In case we would like to have a second interview, what are the best times during the week to meet with you for a thirty minute, informal, in-person interview?

Phone # & E-Mail Address:

Days & Times:

11. Do you know any of the current Wellspring Pow! members/health peer educators or any person who has been a Wellspring volunteer, intern, or employee in the past? If so, whom? What is your relationship to this (these) individuals?

Again, thank you for your interest, time and consideration. We will be in touch!

YOU MUST CLICK THE SUBMIT BUTTON TO COMPLETE THE APPLICATION PROCESS!