Peer Education Intensive Training Weekend Registration

BGSU Recreation and Wellness - Wellness Connection

Peer Education Intensive Training Registration Form
- Date: Saturday, January 23, and Sunday, January 24, 2016
- Time: 12:00 - 6:00 PM
- Location: Student Recreation Center Conference Room
Complete all fields below to enroll.
E-mail*
Full Name*

First NameLast Name
Class Standing*

FreshmanSophomoreJuniorSeniorGraduate Student
Local Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Primary Phone*

Area CodePhone Number
Explain why you are interested in becoming a peer educator. (750 Character Limit)*
Should be Empty:

BGSU Recreation and Wellness - Wellness Connection