9191 Barker CypressCypress, Texas 77433

281.290.3200

Lone Star College-Fairbanks Center14955 Northwest Freeway

Houston, TX 77040832.782.5000

LoneStar.eduaffirmative action/eeo college

Emerging LeadersProgram

HOW DID YOU FIND OUT ABOUT THE EMERGING LEADERS PROGRAM?

Instructor Friend

Orientation and/or Premiere Day Flyer on campus

College e-mail College website

Other (specify:__________________________________)

What do you hope to gain from the Emerging Leaders Program and what contributions would you personally bring to theprogram? (150 word maximum)

In signing this application, I understand the purpose and goals of the Emerging Leaders Program and realize that returning this application does not guarantee my acceptance into the program. I also agree to adhere to the requirements and attendance policy of the program.

Signature:

Date:

Please return this application by Friday, August 27 to the Student Activities Office in College Center, Room 101 (next to the cafeteria).

Questions? Please contact:cfstudentactivities@lonestar.edu or 281.290.3270

The Emerging Leaders Program is the first step toward becoming a student leader at Lone Star College-CyFair. If selected, you will have the opportunity to enhance your leadership skills and personal development, as well as meet other students, staff and faculty on campus.

Program sessions are grounded in theory but defined by practical applications. In particular, participants will have the opportunity to implement lessons learned and knowledge gained in the program.

Program graduates will:• Learn what it takes to become a student leader• Gain life and leadership skills • Become actively involved in campus life• Meet other student leaders at LSC-CyFair• Build self-confidence• Be recognized at the annual Student Awards Banquet and receive a Leadership Certificate

Potential topics:• Conflict resolution• Effective communication• Ethical decision-making• Goal-setting• Group dynamics• Leadership styles• Team-building• Time and stress management

Requirements:• Enroll in at least 6 credit hours at LSC-CyFair or LSC-Fairbanks Center for Fall 2010 and Spring 2011• Currently have and maintain a semester and cumulative 2.5 grade point average• Attendance at an overnight leadership retreat• Attendance at 5 of 6 leadership workshops throughout the year• Complete 10 hours of community service over the course of the year• Attend 3 club meetings each semester

SelectionA selection committee will review the applications and notify applicants of their acceptance status by Friday, September 3. Only 30 participants will be selected for 2010-2011.

Mandatory DatesApplicants must be able to commit to the retreat and 5 of the 6 leadership workshops.

September 17-18The program will begin with an overnight leadership retreat at Camp Allen, a campsite located approximately 40 minutes from campus.

Leadership Lunch SeriesOctober 15, November 19, 2010 andJanuary 28, February 18, March 25, April 15, 2011

EMERGING LEADERS PROGRAM APPLICATION CONTACT INFORMATION

First Name Last Name Student ID #

Address City, State, and Zip Code

E-mail Address

Home Phone Cell/Other Phone

Race (for reporting purposes only) Gender (for reporting purposes only)

Date of Birth

ACADEMIC INFORMATION# of credit hours completed at LSC-CyFair GPA

Major

Semester started at LSC-CyFair

ACTIVITIES/INVOLVEMENTPlease list any current activities, organizations or volunteer work.

REFERENCESList two references (former supervisor, instructor, etc.). Do not use friends, relatives or other students.

First Name Last Name Phone Number

E-mail Address Relationship

First Name Last Name Phone Number

E-mail Address Relationship