Panther Promoting Health Decisions (PhDs) Application
2015-2016
Overview
Panther Promoting Healthy Decisions (PhDs) is a peer education group designed to educate the
PVAMU student as well as the community about the issues that students face today with drugs,
alcohol, sex, stress and hypertension. Panther PhDs members will promote awareness through
educational programs and outreach.
Qualifications for PhDs Membership
Students must meet the following qualifications when applying for PhDs.
1. Be a freshman, sophomore, junior, senior, or grad status when applying.
2. Must be enrolled as a full time or part-time student at Prairie View A&M University
for the entire fall and spring semester (2015-2016).
3. Must be in good standing with the university.
4. Complete the application (by 5pm on Friday September 25, 2015) and successfully
participate in any interview process.
Expectations of PhD Members
1. Successful candidates will be required to sign a Confidentiality and Commitment
Agreement that cover the confidentiality statement, the attendance requirements and
ethical guidelines for Panther PhD members.
2. Complete the Certified Peer Education (CPE) Training program; attend meetings,
scheduled presentation and annual training.
Timeline for PhD Application and Selection
Application Available
September 1, 2015
Application Due
September 25, 2015 by 5pm Student Health Center or
submitted via email at thepvphds@gmail.com
Interviews
September 29 -October 1, 2015
Peer Educators Notified
October 1, 2014
Panther Promoting Health Decisions (PhDs) Application
2015-2016
Name: ____________________________ Email: ___________________________
SID: _________________________________________
Classification (circle one): Freshman
Sophomore
Junior
Senior
Grad
Major: ________________________________
Current Mailing Address: _____________________________________________________________
Phone Number: ____________________________
List your extracurricular activities for 2014-2015
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
________________
Please respond to the following questions (please submit answers on a separate sheet of
paper, 4-5 sentences will suffice)
1. Why do you want to be a part of The Panther PhDs Program?
2. Please describe any related experiences that you think would assist you as a Panther
PhD.
3. Why, in your opinion, do you feel that this program about alcohol, drugs, sexual
awareness, stress, and hypertension issues is important for college students?
4. Have you been involved in any student conduct issues? If yes, Please explain.
Information Release
I, _______________________, give the Student Affairs office permission to check all information
contained in any disciplinary record and release that information to Health Services staff
members for Panther PhD membership purposes only. NOTE: This information will be kept
confidential.
Student Signature: _______________________________ Date______________