Leader to Leader Application

Applications must be received no later than
4:00 P.M. Wednesday, September 29th, 2010.

Please complete the following information. * Required information

Student Leadership Application Form
First & Last Name	*
Student ID #	*
Local Address	*
City	*
State	* ZIP Code *
Phone Number	*
E-mail Address	*
Year in school	* (i.e. 1st year, 2nd year, etc.)
Gender	Male Female *
How did you hear about the Leader 2 Leader?	*
Please list any special needs, medications, or allergies, else state none.	*
Shirt Size:	Small Medium Large XLarge XXLarge
Please answer all the following required questions...
1. On a scale of 1 to 10 where would you rate your leadership experience?
2. Please list all clubs, organizations, volunteer positions, and student assistant positions that you have participated in while attending Stanislaus.
3. If you had to pick five words that best describe you, what would those words be?
4. What do you hope to learn as a participant in this program?
	After your application is received and reviewed, you will be notified via email on your selection to attend Leader 2 Leader.