Application deadline: Thursday, August 13
Mailing Address City ST Zip
Preferred Phone Email: Student ID Number
Curriculum Number of credits presently taking
Number of credits completed Overall G.P.A.
Present G.P.A Projected Date of Graduation
Long Term Goal
Employment Status: Full-time Part-time Unemployed
If employed, how many hours per week? Employment status next year?
If selected would there be anything that would hinder your availability to serve as a Bladen Community
Activities on Campus you participate in:
Hobbies and Interests:
Have you read the by-laws of the BCC Ambassador program?
I agree to abide by the by-laws if selected as an Ambassador?
In essay form, please explain why you are interested in representing BCC as an ambassador and what special
skills or experiences you would bring to the position. (Use an additional sheet of paper).
Please give the names of three members of the college community (faculty, administrators, or staff) that have
agreed to give you a recommendation for the Ambassador program.
Please return application and nominations to Linda Burney - Building 7, Second Floor or either by
mailing to Linda Burney, Bladen Community College Foundation, P. O. Box 384, Dublin NC 28332
or email firstname.lastname@example.org. Please type or print in blue or black ink.