* 1. First Name:

* 2. Last Name:

* 3. Email address:

* 4. Major(s) & Minor(s):

* 5. Academic year in SpringĀ 2015:

* 6. Which of these areas would be of greatest interest to you?

* 7. Have you had any prior health education training, relevant courses (nutrition, diabetes seminar, etc), or volunteer experiences? If yes, please specify.

* 8. Here at DiET we are committed to fighting diabetes in underserved areas of Alabama through health education. Why do you want to be a part of our mission? (Please limit responses to under 150 words)