Before you submit your application form, please make sure you havemet and completed all of the requirements stated in the checklist below.

CHECKLIST AND INSTRUCTIONS FOR APPLICATION

Complete at least 30 credit hours.

Earn at least a 3.0 cumulative GPA.

Submit a 1 page essay describing your leadershipphilosophy.

Attach a resume.

Provide 1 letter of recommendation from a TWU faculty/staff member.

Unofficial transcript.

SUBMIT APPLICATIONS TO THE CENTER FOR STUDENT LEADERSHIP

STODDARD HALL, ROOM 103

OR

MAIL TO P.O. BOX 425706, DENTON, TX, 76204

Center for Student Leadership Membership Application

Name:(Last name/ First name/Middle initial)

Student ID:

Date of Birth: (month/day/year)

Gender: Male Female

Are you a U. S. Citizen? Yes No If no, (Country of citizenship)

Ethnic Group: (check all that apply)

American Indian or Alaskan Native Asian or Pacific Islander

African American Hispanic/Mexican American/Puerto Rican

Caucasian Other: (please specify)

Permanent Mailing Address: (Where you receive mail when not in school)

Street Address/PO Box:

City: State: Zip:

School Mailing Address: (If living on campus and wish to receive mail, please provide P.O. Box)

Street Address/PO Box:

Residence Hall:

City: State: Zip:

Academic Information:

Major: Minor:

Number of Credit Hours:

Indicate Classification: Sophomore (30-59hours) ____ Junior (60-89hours) ____ Senior (+90 hours) ____

Expected month/year of graduation:

Cumulative GPA (3.0 or higher):

2

Email: _____________________________________

Academic Achievements, Co-curricular Activities, and Employment

1. College Academic Achievements and Recognition:

Honor societies, professional organizations, academic awards, Dean’s List, etc.

2. Co-curricular Activities: Do you currently hold leadership positions in community service projects, student organizations, Greek organizations, Student Government Association, Residence Hall Association, the Lasso, Student Development, and Orientation Leader etc.?

3. Employment Experience: List all paid positions within the last 2 years, including any while attending college classes and/or internships, practicums, student teaching, etc.

3

Short Answer Questions

1. Describe your leadership experiences.

2. Why is it important for you to develop leadership knowledge and skills?

3. What do you expect to contribute to the Center for Student Leadership?

4. How would the Center for Student Leadership support your future goals?

5. Does your department require an internship or practicum(s)? If so, how many, with

whom, and how many hours/days/weeks did you work?

4

5

CENTER FOR STUDENT LEADERSHIP Student Information Sheet

Name:

Phone Number:

Email:

If possible, please provide 2 emails in the event that one should

not work.

T-Shirt Size:

Dress Shirt Size:

Jacket/Blazer Size:

Special Dietary Needs:

Allergies:

Emergency Contact Name

Emergency Contact Phone Number

Emergency Contact Relation to Student

Request for Letter of Recommendation

Due Date:

Personal Information

First Name Last Name

Street Address:

City: State: Zip Code:

Telephone Number:

This letter of recommendation is for

Center for Student Leadership membership application

To Whom Should This Letter Be Addressed?

Contact Name: Judy Elias Department: Center for Student Leadership

Street Name or P.O. Box: 425706 City: Denton

State: Texas Zip Code: 76204

This Letter of Recommendation Should Emphasize (pick four areas):

Academic Record Research Experience

Scholarship Leadership Experience

Employment Campus Activities

Community Service Personal Character

Other:

Academic Record

Total Number of Hours Completed:

Cumulative GPA: Major GPA:

Major: Minor:

Graduation Date:

Professional Goals