Peer Educator Application

Peer Education Program at Wagner College:

Students Empowering for Change (SECs)

2016-2017 Application


Students Empowering for Change (SECs) is a group dedicated to facilitating and shaping an evolving, safe, and inclusive campus environment by developing peer to peer communication. This group seeks to empower peers by providing information and support about responsible decision making and positive role-modeling to help improve the Wagner campus community. This is a peer education group advised by Campus Life administrators. Four subgroups within SECs focus on the following peer-to-peer educational topics: alcohol and drug education, diversity, wellness, and healthy relationships. All members are nationally certified through the Bacchus and Gamma Network.

Eligibility Requirements:

  • Applicants must have a 2.5 GPA and be in good disciplinary standing. First year students and transfer students without a Wagner GPA can apply to be a Peer Educator; their membership will be contingent upon a GPA check.
  • Applicants must complete the application.
  • Candidates must have two references.  One of these references must be completed by a Wagner faculty or staff member.
  • Candidates must sign up for an interview in the Health Center (Campus Hall, Room 127) or by calling (718) 390-3158 when he/she turns in his/her application. A member of the Health & Wellness staff and a former Peer Educator will interview all students.

Selection Criteria:

Preference will be given to Wagner College students who have demonstrated the following:

  • Helping fellow students be successful at Wagner College or while you were in high school.
  • Assisting and contributing to a positive peer-to-peer environment.
  • Full Time enrollment at Wagner, must possess a 2.5 GPA and be in good disciplinary standing.
  • Have a history of student leadership/working with peers/groups in high school or college, and involvement in campus life.
  • Sensitivity to and interest in issues such as relationship building, alcohol and other drugs topics, diversity, and wellness.
  • Enthusiasm and commitment for working on a team and making a difference.
  • Ability to be a resource and refer students to campus services.
  • Ability to model appropriate behavior for peers.
  • Availability to attend Peer Educator Training and meetings throughout the academic year are mandatory.   The training schedule will be made available during  the fall semester.

If you have any questions, please call the Center for Health & Wellness at 390-3158 or email us at

Peer Educator General Responsibilities:

A Peer Educator at Wagner:

  1. Serve as a positive role model for their peers.
  2. Maintain a 2.5 GPA and be in good disciplinary standing.
  3. Serve as a resource and role model as a peer educator regarding safety and wellness for individual students and the community.
  4. Practice confidentiality and discretion as defined by the program.
  5. Attend formal training sessions as scheduled.
  6. Plan at least one larger group program and several subgroup programs during the academic year as well as participate and support in programs as they relate to Orientation 2016.
  7. Attend weekly meetings as scheduled.
  8. Maintain ongoing communication within the Peer Education Program with students and advisors.

Wagner College Peer Educator Application

Please return your application to the Center for Health & Wellness, Campus Hall, Room 127 or e-mail application to

*Any questions should be directed to the Center for Health & Wellness at (718) 390-3158 or via email at

Name: ___________________________________ Today’s Date:________________ College Address: ________________ College Phone: _______________ Box#: _______________ Home Address (for commuters and/or summer mailings): ___________________________________________________________________________________ Cell Phone: ___________________ Class Standing (currently): _________________________ E-mail Address Most Used: T-Shirt Size: _________________________ Cumulative GPA: __________________________ Major: _________________________

  1. Describe the role of a Peer Educator, as you perceive it.
  2. What personal qualifications would you contribute to the success of the Wagner College Peer
    Education program? What qualities and skills do you possess that you believe will make you a
    successful Peer Educator?
  3. Please specify which subgroup of the Peer Education program you are interested in joining and how
    you feel you contribute to that group. Are there any specific experiences of your or personal qualities
    that you think make you a good fit for that group?
  4. In your opinion, what are some issues that your peers experience while at college? How can you
    impact these experiences?

I acknowledge that the information contained in this application is factual and is a realistic assessment of my abilities. Because I recognize that being a Peer Educator carries with it privileges and responsibilities, if chosen, I promise to act as a role model for all students at Wagner College and act in accordance with the Peer Educator expectations and follow the policies and procedures set forth in the Wagner College Student Handbook. If this form is submitted electronically via e-mail, the e-mail record will serve as your signature.


Date Received in Health Ctr. __________________________________________

Signature:_________________________________________ Date:_________________



Center for Health & Wellness, 1 Campus Road, Staten Island, NY 10301, Phone: 718-390-3158, Fax: 718-420-4170

Applicant’s Name (Please Print) _____________________________________________________

____ I waive the right of access to this reference ____ Retain the right to access to this reference

I understand that this choice will not affect my candidacy in any way.

____________________________________________ ___________________________ Applicant’s Signature Date

This student has applied for a Peer Educator position in the Campus Life Division. Please complete the following questions and return to: Center for Health & Wellness, Campus Hall, Room 127 or attach as a file via e-mail at;; Thank you!

  1. Please indicate how well you know the candidate and in what capacity.
  2. What skills/leadership qualities does the candidate possess to be a Peer Educator?
  3. Please comment on the candidate's ability to deal with their peers and any interpersonal strengths, experience or qualities worth noting.
  4. What are the candidate’s strongest skill areas? Areas for improvement?

Submitted by:
Name (Please Print): Position: ____________________________ Signature: __________________________________ Date: ____________________________