PEERS PROJECT APPLICATION

PEERS PROJECT APPLICATION

Please answer the following questions:

PEERS PROJECT APPLICATION

Position: Area Coordinator
Job Description: Conduct the PEERS Project in participating public schools and associated middle schools. Act as a resource for Right to Life of Southwest Indiana and the community at large in promoting the social, physical, mental and spiritual benefits of making healthy lifestyle choices such as abstinence from various risky behaviors (ie- sexual activity, drugs, and/or alcohol).
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Format: (000) 000-0000.
E-mail*
example@example.com
S.S.N:
Date Available to Start:
Desired Salary:
How did you hear about this job posting?*
Please answer the following questions:
As PEERS Project is an entity of Right to Life of Southwest Indiana, will you commit to upholding the mission and values of Right to Life?*

YesNoMaybe
Why do you feel you are qualified for this position?
Why do you feel that it is important for adolescents to learn from their peers on the topics of abstinence and avoiding risky behaviors?
Do you have experience working with middle school and high school students? If so, what knowledge have you gained with that experience?
As an Area Coordinator, you will be required to travel to area schools several times a month. Will transportation be an issue?
Would you be willing to submit to a background check?*

YesNoMaybe
Are you a citizen of the United States?*

YesNo
If no, are you authorized to work in the U.S.?

YesNo
Have you ever worked for PEERS Project or Right to Life of Southwest Indiana?*

YesNo
If yes, when?
Have you ever been convicted of a felony?*

YesNo
If yes, explain?
Are you a veteran or active military?*

YesNo
If yes, please give dates of service?

Please provide two references that we may contact in regard to your possible employment:

Rows	Full Name	Address	Contact Number
1
2

Please provide Education Information:

Rows	Dates Attended	Address	Did you Graduate?
High School
College
College 2

Please provide Previous Employment:

Should be Empty:

Supervisor

Dates Employed