Reyburn Peer Counseling Application        2026-2027

PLEASE send your TEACHER this recommendation form-


Peer Counselors are a selective group of students who are held to a higher standard of rules and accountability.  Should you be selected to be in this program, please note the following standards and requirements you are making a commitment to uphold:
-Confidentiality must be maintained at all times, both inside and outside the classroom with a few legal exceptions.
-Gossip and mean-spiritedness will not be tolerated.
-Respect and positive attitudes must be shown to all staff members and fellow students.
-Respecting the Peer Counseling Program means complying with all classroom rules and requirements and demonstrates your respect of the peer Counselling Advisor.
-Abiding and supporting all school rules, including the CUSD dress code, promotes a mindset of respect, even if you do not agree with all the rules.
-Choosing to promote an abstinent drug-free life means not using any illegal or non-prescribed drugs (including all forms of tobacco and alcohol)
-A minimum 2.5 GPA must be maintained at all times.
-Excellent attendance is mandatory.

If you cannot personally agree to follow and support all of the above standards and requirements, please DO NOT apply.  **Note: Initial students are subject to a four week probationary period.
Email *
If you agree to follow and support ALL the above standards and requirements, maintain good morals/values, and character at all times, and avoid any behaviors that would bring damage or shame to the credibility and integrity of the Peer Counseling Program or Reyburn Intermediate School itself, then please sign below.  (First Name and Last Name)* *
Student ID Number *
Last Name, First Name *
Grade for Fall 2026-2027 *
Gender *
What is your OVERALL grade point average?  Normally you would have this verified by your counselor/registrar- I will be double checking and if you have any questions how to find this please let me know. *
Please tell me the name of teacher you sent your recommendation form to fill out...
As part of the application procedure, please note that your teachers and counselor will be confidentially surveyed about your current and post record regarding performance in academics, character, discipline issues, leadership qualities, communication skills, confidentiality, integrity, and attitude.    Please check the box below indicating that you understand that the advisor may contact your current teachers/counselor. *
Required
Reflection questions
Please type your response to the following prompts (no longer than one page in length for all three questions)
What character qualities can you bring to this program?* *
What are your greatest strengths that would make you an excellent Peer Counselor? *
What other activities are you involved in?* *
Thank you for applying for the Reyburn Peer Counseling Program!
7th Grade ONLY: The next steps. . . your application will be reviewed and you will be contacted by Mrs. Jones to set up an interview time.  Group interviews will be held in person mid-April, and will include Mrs. Jones and 1-2 current peer counseling students.  Interviews should last between 10-15 minutes and just provide us an opportunity to get to know you better.  After the interviews, you will be contacted letting you know if you have been accepted into the program and that will also be passed along to your counselor.
6th Grade ONLY: No interviews will be conducted prior to selection. Recommending teachers will receive an email in regards to your character & application. 
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