Eating Disorder Peer Education Program (EPEP)
University Counseling Service
University of Iowa

The questions in this application are meant to ensure that everyone who applies to this program has carefully reflected about his or her appropriateness as well as the expectations for involvement with the Eating Disorder Peer Education Program (EPEP). Self-reflection and honesty are integral parts of being a helper and peer educator. There are no right or wrong answers.

Name:

Year in School: Major:

Address:

Phone Number: Email:

Best Way to Contact You:

Why is it important to you to be an EPEP Volunteer, other than to help people?

What do you believe about the source of and impact of eating disorders and disordered eating on individuals? In what ways might your own beliefs and perspectives have been influenced by society, media, and/or stereotypes?

EPEP volunteers work with peers from various cultural backgrounds (race, gender, sexual orientation, ability/disability, religion,  age, etc.). What are the strengths and barriers you bring to working with people who are different from you?

How will you maintain peer confidentiality?

As part of the EPEP program, we recognize and challenge the often difficult and conflicting messages from society about our bodies, our lifestyle choices, our health, and our eating habits. We know that each individual experiences and manages these messages and pressures differently. Please describe an experience or situation in your life when you encountered pressure or a message about yourself and how you dealt with it.

Please rate the following according to your level of interest, experience, and skills:

         Scale: 0= none; 1= a little bit; 2= some; 3= quite a bit; 4=very much

Please use this space to provide any other information, explanation, or input about any of the questions above.

Please provide three references with your application. These should be individuals who know your work as well as can speak to your characteristics as a person and future peer educator.

Reference #1: Phone #:
Reference #2: Phone #:
Reference #3: Phone #:

Attendance at training seminars in the fall is mandatory. Will you be able to attend weekly meetings on Mondays from 9:30-11am, starting on September 10?

Yes No Maybe, Let's Discuss

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The deadline for submitting your application is September 14.

Disclaimer: EPEP training does not take the place of professional help for body image, disordered eating, or eating disorder concerns. While students who have struggled with these concerns in their own lives are welcome to participate in this training and volunteer opportunity, it is imperative that they have reached a stable and healthy stage in their recovery prior to doing so. If you have any personal issues with disordered eating or an ongoing eating disorder, consult with Eva Schoen (335-7294, eva-schoen@uiowa.edu). This information will be kept confidential. EPEP volunteers clearly identify themselves as peer helpers and do not claim any expertise in counseling or in the treatment of eating disorders

           Application form modeled after EDPA application form, Darthmouth College, Hanover, NH