Volunteer/Peer Mentor Application

Name:

Local Address:

Home Phone:

Message Phone:

Email:

Class Level: 1st Year 2nd Year 3rd Year 4th Year 5th or Later Year Graduate

Academic Major/Degree Program:

Day of the Week and Time you would like to Volunteer:

Date of Birth:

Gender/Gender Identity (optional) :

Ethnicity (optional):

Sexuality (optional):

What Organizations on campus have you been involved with in the past (or are currently working with now)?

Pertinent skills or Interests:

Previous counseling/group experience (formal or informal):

References (someone who knows your work/volunteer experience -- UNC references preferred). Please provide names, addresses, and email addresses of two references (Include relationship to you):

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Please answer the following questions:

What do you think are the needs of students on campus regarding lesbian, gay, bisexual, transgender, and queer issues?

What personal characteristics, skills, and/or experience do you have that will help you in the position of volunteer/peer mentor?

What are your specific reasons for wanting to be a volunteer/peer mentor for lesbian, gay, bisexual, transgender, and queer issues?