Student Leadership and Development

SLP Application

Applications must be received no later than
4:00 P.M. Wednesday, August 5th, 2009.

Please complete the following information. * Required information

Student Leadership Application Form
Full Name	*
Student ID #	*
Local Address	*
City	*
State	* ZIP Code *
Phone Number	*
E-mail Address	*
Permanent Home Address
City
State	ZIP Code
Permanent Phone Number
Year in school	* (i.e. 1st year, 2nd year, etc.)
Gender	Male Female *
Did you transfer to CSU Stanislaus from another institution?	Yes No *
If yes, what is the name of the institution?
Will you be a Village resident in Fall 2009?	Yes No *
Will you be staying in the Village for SLP?	Yes No *
How did you hear about the Student Leadership Program?	*
Please list any special needs, medications, or allergies, else state none.	*
Shirt Size:	Small Medium Large XLarge XXLarge
	Important: Your application is not complete without a $20 deposit in check form, delivered by deadline to the Offiice of Student Leadership and Development. Yes, I understand and will make arrangements for the deposit.
Please answer all the following required questions...
1. What interests you about the Student Leadership Program?
2. Please describe any past leadership and volunteer experience.
3. If you had to pick five words that best describe you, what would those words be?
4. The goal of the program is to help students develop their leadership skills. What challenges do you identify with when it comes to leading others, or wanting to develop into a more refined leader?
5. 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 the CSU Stanislaus Student Leadership Program.