Information

Please fill out this form if you are: a member of the class of 2019,2020, or 2021 and are interested in learning more information and/or joining our PHE team! Submitting this application means that you agree to receive future information regarding peer health education, our peer health educator team, and application information about our 2018-19 team!

**note: information will be sent via scranton email starting in the Spring 2018 semester. PHE recruitment will begin in Febraury 2018! **

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* 1. First Name

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* 2. Last Name

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* 3. Email Address (@scranton.edu)

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* 4. Confirm email address (@scranton.edu)

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* 5. Class Year

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* 6. How did you hear about our PHE program? (please check all that apply)

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