All materials due: March 15

First Name:
Last Name:
Gender:
Birthdate:
College ID:
Local/Campus Address:
City:
State:   ZIP:
Local Phone:
Cell Phone:

Current Status:
Major:
Fall GPA:   Cumulative GPA:


What past experiences have you had that spark your interest in becoming a peer counselor?



What personal characteristics or qualities do you feel you possess that would enhance your abilities to do this job well?



Please list your interests, hobbies, and Canisius College Clubs/Activities and work experiences.



Please list any leadership positions you currently hold or have held (include dates).



Please list any honors and/or awards that you have received.



References: (3 letters)
Please have three people submit letters of recommendation on your behalf to the COPE Counselor in Old Main 101 by March 15.  One recommendation should be from a work supervisor, one from a Canisius College faculty or staff member, and one from a peer. Please note that COPE staff members will not be writing letters of recommendations.


All materials due: March 15


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