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Peer Coach Application
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First Name
Last Name
Preferred Name
Cell Phone # (by providing your number you understand this information will be shared with your peer coach)
Email Address- if you are a current Rockhurst student, please enter your RU email
Hometown
Gender Identity (check all that apply)
Gender Identity (check all that apply)
Male
Female
Non-binary
I identify differently than above (please enter in the space below)
I prefer not to answer
Ethnicity Identity (check all that apply)
Ethnicity Identity (check all that apply)
Asian
Black/African
Caucasian
Hispanic/Latinx
Native American
Pacific Islander
I identify differently than above (please enter in the space below)
I prefer not to answer
Living Arrangements
Living Arrangements
Off campus
McGee
Corcoran
Have either of your parents/guardians completed a Bachelor's degree program?
Have either of your parents/guardians completed a Bachelor's degree program?
Yes
No
Potential Major
Why did you choose Rockhurst?
Why do you want a Peer Coach?
What is the biggest concern or challenge you think you will face in your first year?
I agree that I want to have a peer coach assigned to me and I will approach this relationship with an open mind and willingness to learn new things. I agree that I will respond to communications from my peer coach. I understand that I will be required to visit with my peer coach in person 3 times a semester. I agree to attended one group event a month with my peer coach. I understand that my peer coach is here to guide and support me and will respect the time that they put into the coaching relationship.
Type your name to confirm you have read and understand the statement above:
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