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Peer Facilitation Application
Student Response Section: We appreciate your interest in joining this class. Please fill out the following application HONESTLY and to its entirety. Applicants who submit incomplete applications will not be considered for this course. Submission of application does not guarantee course approval
* Indicates required question
Name: (first and last)
*
Your answer
Student ID number
*
Your answer
What grade level will you be during the 2016-2017 school year?
*
Junior
Senior
Overall GPA
*
Your answer
Counselor name
Your answer
Which two teachers are your asking to recommend you for this course?
*
Your answer
Do you have any discipline infractions?
*
(discipline infractions include but are not limited to: personal teacher or department detentions, ISS or OSS)
Choose
No
Yes, I will explain in the next section
Do you have more than 2 unexcused absences from last school year?
*
Choose
No
Yes, I will explain in the next section
Do you have more than 3 tardies from last school year?
*
Choose
No
Yes, I will explain in the next section
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