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Profile of Peer For Peer Counselling

The document is a confidential profile form for peer counselling, collecting personal, academic, career, family, stress, and social information from individuals. It includes sections for personal details, academic challenges, career aspirations, family background, mental well-being, and expectations from the counselling program. The information gathered will be used solely for counselling purposes and kept confidential.

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subhamcult
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11 views2 pages

Profile of Peer For Peer Counselling

The document is a confidential profile form for peer counselling, collecting personal, academic, career, family, stress, and social information from individuals. It includes sections for personal details, academic challenges, career aspirations, family background, mental well-being, and expectations from the counselling program. The information gathered will be used solely for counselling purposes and kept confidential.

Uploaded by

subhamcult
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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PROFILE OF PEER FOR PEER COUNSELLING

(Confidential & for Counselling Purposes Only)

Section A: Personal Information


1. Full Name: __________
2. Age: ___
3. Gender: ☐ Male ☐ Female ☐ Other
4. Contact Number: ______
5. Email Address: ______
6. Residential Address: ______
7. Marital Status: ☐ Single ☐ Married ☐ Other
8. Hobbies & Interests: ______

Section B: Academic Information


9. Program of Study: ______
10. Year of Study: ☐ 1st Year ☐ 2nd Year ☐ Other
11. University/College Name: ______
12. Current CGPA (if applicable): ____
13. Do you face any academic challenges? ☐ Yes ☐ No
- If yes, please specify: ______
14. Preferred Learning Style: ☐ Visual ☐ Auditory ☐ Kinesthetic ☐
Reading/Writing
15. Do you feel comfortable with your current academic workload? ☐ Yes ☐ No
- If no, what are the major difficulties? ______

Section C: Career Aspirations


16. What is your long-term career goal? ______
17. Do you have a specific career plan after Completing Integrated B Ed M Ed
course? ☐ Yes ☐ No
- If yes, please specify: ______
18. Are you preparing for competitive exams? ☐ Yes ☐ No
- If yes, which exam(s)? ______
19. Do you feel confident about achieving your career goals? ☐ Yes ☐ No
20. Do you need guidance for career planning? ☐ Yes ☐ No

Section D: Family Background


21. Father’s Occupation: ______
22. Mother’s Occupation: ______
23. Number of Siblings: ___
24. Do you live with your family? ☐ Yes ☐ No
25. Do you feel family expectations add stress to your academic life? ☐ Yes ☐
No

Section E: Stress & Mental Well-being


26. Do you experience stress or anxiety related to academics?☐ Yes ☐ No
27. Do you experience stress from personal or family matters? ☐ Yes ☐ No
28. What is your primary source of stress? ☐ Academics ☐ Family ☐ Career ☐
Relationships ☐ Health ☐ Financial ☐ Other (Specify): ______
29. How do you usually cope with stress? ☐ Talking to friends/family ☐
Exercising ☐ Meditation/Yoga ☐ Watching Movies/Listening to Music ☐ Other
(Specify): ______
30. Have you ever sought professional counselling or therapy? ☐ Yes ☐ No
31. Do you think peer counselling would help you manage your stress better? ☐
Yes
☐ No

Section F: Social & Emotional Well-being


32. Do you find it easy to make friends? ☐ Yes ☐ No
33. Do you feel lonely or isolated at times? ☐ Yes ☐ No
34. Do you have someone to talk to when you feel stressed?☐ Yes ☐ No
35.How comfortable are you in discussing your problems with others?
- ☐ Very Comfortable
- ☐ Somewhat Comfortable
- ☐ Neutral
- ☐ Uncomfortable
- ☐ Very Uncomfortable

Section G: Additional Information


36. What support do you expect from a peer counselling program?
- ☐ Academic Support
- ☐ Career Guidance
- ☐ Emotional Support
- ☐ Stress Management
- ☐ Other (Specify): ______
37. Would you like to participate in peer counselling sessions? ☐ Yes ☐ No
38. Any other comments or concerns you’d like to share? ______

Declaration
I confirm that the above information is accurate to the best of my knowledge. I
understand that the data provided will be kept confidential and used only for
counselling purposes.

Signature: ______ Date: ______

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