Application for Peer Health Education
NOTE: You must be either a first or second year to apply for the position, and be able to
take the 3-credit training course in the fall of 2012 (T/R 2-3:15) at UVa.
The deadline for submitting applications is THURSDAY, MARCH 1ST
at 5:00 PM in the Office of Health Promotion in the basement of
Student Health. No late applications will be accepted!
For questions and additional information please contact PHE Intern, Hannah Harris, at
firstname.lastname@example.org or PHE Coordinator, Hillary Barry, at email@example.com.
Thanks for your interest and enthusiasm in the PHE program!
Need more info? Please visit http://www.virginia.edu/studenthealth/phe.html
Becoming a Peer Health Educator will involve:
Participating in a three-credit peer health educator course in the fall of 2012
Attending weekly membership meetings (Tuesday 5:00-6:00PM)
Conducting several 1 hour outreaches for various student groups
Holding a weekly office hour at Student Health for patients needing assistance
with first-time gynecology exams, birth control and contraceptive options,
nutrition, and men’s health issues
Attending weekly membership meetings Tuesday (5:00-6:00PM)
Personal Information: (Type or Print Clearly)
Student ID #_____________________________________________________________
Local Address ___________________________________________________________
Local Phone Number ______________________________________________________
Email Address ___________________________________________________________
How did you learn about the Peer Health Education program? _____________________
Answer the following on a separate sheet of paper. Include your STUDENT ID (on
your student ID card) in the top right hand corner. DO NOT write your name on
your answer sheet.
Short Response (Please limit each answer to 150 words)
1) Why are you applying to be a Peer Health Educator? What do you hope to achieve
for yourself and others?
2) What previous experiences (academic, volunteer, personal or work-related) have
prepared you in some way to be a UVA Peer Health Educator or to deal with some of
the issues that the PHEs address?
3) Choose ONE of the following (limit answer 200 words)
a) What is something you secretly like but pretend to hate?
b) What has been an embarrassing moment that turned out to be a wonderful
Long Response (Please limit answer to 400 words)
4) What are common college student attitudes or issues that you would like to see
challenged? What are some ways you think we can challenge these attitudes/issues?
5) Please list all other commitments that you anticipate to have in the coming school
year. See Example.
Activities Role Time Commitment (hr/week)
Club XYZ President 10 hr/week
Memorial Gym Employee 4 hr/week
… … …
Please be cognizant of the time and personal commitment needed to be involved with the Peer Health Education Program.
We value students who work, volunteer, and are involved in the UVa and Charlottesville communities but must
ensure those applying understand this commitment.