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* 1. Name:

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* 2. Year of study:

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* 3. Program / major:

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* 4. E-mail address:

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* 5. What song best describes your work ethic?

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* 6. What do you hope to gain from the Peer Connections program? 

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* 7. What do you like to do in your spare time? 

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* 8. Does pineapple belong on pizza? 

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* 9. Please justify your answer to question #8.

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* 10. Additional comments / questions / concerns (optional):

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