PEEPS application form

Thank you for your interest in Cornell Plantations' PEEPS program! Please fill out this application form and submit by February 25th (returning students) and March 1st (new students). In addition to this online form, we must also receive a signed commitment pledge and two reference forms.

Download the commitment pledge.

Download the reference form.

Contact Donna Levy at dl51@cornell.edu, or 254-7259 with any questions.

Contact Information

Name: *

e-mail address:

Gender: *

male

female

Date of Birth: *

Current School: *

Current Grade: *

Street Address: *

City: *

Zip Code: *

Please enter zip code if it's not listed above:

Parent/Guardian #1

#1 Name: *

#1 Phone: *

#1 e-mail: *

Parent/Guardian #2

#2 Name:

#2 Phone:

#2 e-mail:

I live with: *

Do you have transportation to and from Cornell Plantations (parents, walk, bike, bus, etc.)? :

yes

Emergency Contact

Name: *

Street Address: *

City, State, Zip Code: *

e-mail address: *

Are you a returning PEEPS participant?: *

Yes

If you answered yes, PLEASE ANSWER THE TWO QUESTIONS BELOW, THEN SUBMIT YOUR APPLICATION (please note: A commitment pledge is still required but references are not necessary).

If you answered no, PLEASE ANSWER THE SHORT ANSWERS FOR NEW APPLICANTS.

Short answers for returning PEEPS

Why do you want to return to PEEPS?:

How would you like to build on your previous experience?:

Please submit your application. (Note: A commitment pledge is still required but references are not necessary).

Short Answers For New Applicants

About You

What do you like to do during your free time? :

Have you ever worked alongside someone older than you? What was the experience like for you?:

Have you ever worked alongside someone younger than you? What was the experience like for you?:

Do you have a favorite plant? Why?:

What public speaking experience have you had, if any?:

Is there anything else you would like us to know about you?:

Program Expectations

How did you hear about PEEPS?:

Why do you want to be part of PEEPS?:

In what way do you think this program can meet your expectations for personal growth?:

What skills do you hope to gain from this experience? :

Ideas for the Future

Do you have plans after you graduate high school? :

How do you think young people can effectively engage in environmental conservation?:

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PEEPS application form