Contact Information Name: Today's Date: Local Address (or Dorm): City: State: Zip Code: Phone Number: Email: School: Major: Year/Class: Interview Sign-Ups Please give me 3 different days/times that you are available to meet with the Director of KYS for a 15-20 minute interview. DayTime About You 1. Describe why are you interested in participating in the Know Your Status program? What do you feel you could contribute to the program? 2. List any extracurricular activities you are currently involved in (hobbies, clubs, sports, dorms, fraternity, sorority, etc.) Please note leadership positions held. 3. Assess your ability to work with your peers in an educational role on health issues in terms of your strengths, weaknesses and past experiences. 4. When volunteering with Know Your Status, you may encounter many types of people. Please tell us about your experience with and perspective on people of different ethnicity, gender, sexual orientation, ability, religion, lifestyles and values. 5. Where did you hear about Know Your Status?
