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Peer Teacher Program Application

Faculty Member's Information:

Name:

Department:

Phone:

E-Mail Address:

Nominated Student's Name:

E-Mail:

Current Address:

City: State:

Zip Code:

Telephone Number:

Student 700#:

Major Department:

Class Standing (junior/senior):

Average (GPA) in Major Courses:

Responsibilities:

Faculty Recommendation:

Is this course part of First-Year Connections? Yes No

 
 
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