SHORE
Students Helping Other Reach Excellence

MEMBER FORM

NAME                                                               STUDENT #                                       

PHONE                                                              E-MAIL_______________________

ADDRESS__________________________________________________________

MAJOR                                                   GPA                                       

ACADEMIC STATUS                                (Freshman, Sophomore, etc.)

ACTIVITIES:  Please indicate the activities you are interested in:

_____Preparing awareness events (e.g. Alcohol Awareness Carnival)
_____Preparing class presentations
_____Preparing written information materials
_____Working at awareness events
_____Presenting to classes, groups, teams
_____Advertising
_____Other:____________________________________________________________

TOPICS:  Which topics are you passionate about teaching your fellow students:

_____Alcohol and Drugs
_____Sexual Assault
_____Healthy Eating and Body Image
_____Relationships
_____Stress Management
_____Self-Esteem
_____ Mental Illness
_____Time Management
_____Communication
_____Study Skills
_____Conflict Resolution
_____Suicide Prevention
_____Sex
_____Diversity
_____Dating
_____Motivation
_____Anger Management
_____Others:___________________________________________________________

SKILLS AND STRENGTHS:  Describe the skills and strengths that you have to contribute:

RETURN MEMBER FORM TO COUNSELING SERVICES.