Kansas State University Honor & Integrity System

Honor & Integrity Peer Educators (H.I.P.E.-Believe It!) Organization
Application Form

Please print, fill in information, and return to contact below.

Name (Please Print)_____________________________________

Email Address_________________________________________

Local Address__________________________________________

Local Phone____________________________________________

Classification (please circle) Fr Soph Jr Sr 5th yr Major________________

Semester Hours Enrolled in Fall 2007_____________

Will you have a job? No Yes (where:_______________________________)

Approximate # of hours per week you work: _______

Are you in any extracurricular activities (clubs, sports)? No Yes (type:_______________________)

Approximate # hours per week you are involved: _____

Are you in the Greek system? No Yes (which one:_______________________)

Approximate # hours per week you are involved in Greek activities: _____

High School Attended___________________________________

Activities in high school (include sports):

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

Please give two references (may be on or off campus, former high school or home town):

1. Name________________________________Phone________________________

2. Name________________________________Phone________________________

*Important: Please attach a typed one page letter telling us why you would like to be considered for this organization and what you feel you can contribute to the group. Give usa glimpse of some of your future goals.

Applications accepted any time in 215 Fairchild Hall. For further information, please contact Helene Marcoux at (785) 532-2594, email (helene@ksu.edu) or access the Honor & Integrity System web page.