Peer Assistant Application - 2019-2020
PLEASE READ THE SEPARATE INFORMATION PACKET BEFORE COMPLETING
Application must be typed
Name: _______________________________________________CCC ID #________________________________
Home Phone: ____________________________ Cell Phone (if different): _________________________
CCC Email: ____________________________________________________________________________________
Cumulative GPA: _____________________ Major: ________________________________________________
Indicate: Which of the following positions you are most interested? Place a 1 and 2 in the box
of your first and second choice, etc. Please see detailed descriptions online before deciding.
Note: not all positions may be available at this time.
Disability Resource Center (DRC)
Student Life and Leadership
Signature: I hereby submit my application and agree that all information is true to the best of my
Signature: _____________________________________________________ Date: __________________
Submit: All materials (Application, typed resume including names and contact information of three
references) by e-mail to email@example.com or to Robin Dryden in the Community Center.
Applications must be complete to be considered