LEADERSHIP INSTITUTE APPLICATION
Congratulations on taking the first step towards enrolling in the Century Leadership
Institute! Please complete the application and email it to
email@example.com or turn it in at The Connection (W1205) no later
than noon on Friday, February 7, 2020. All applicants will be notified of their
admissions status no later than Friday, February 14, 2020 via phone or email after a
thorough review of their application materials.
Student ID #:
Last Name: Pronouns:
Program/Major Currently Enrolled in at Century:
Application Questions: (please use the back or other paper as needed)
What does leadership mean to you?
Please explain your leadership experience:
What would you like to gain from this experience?
What motivated you to apply for the Leadership Institute?
Please indicate which session/s you would like or can attend: (Schedules may change depending on interest)
Mondays from 3:00 – 4:30 PM (Feb 24
Fridays from 10:15 – 11:45 AM (Feb 21 - April 3)
D2L Online (Feb 24 - April 6) *online only, however,
in person sessions are most recommended*
RECOMMENDATION LETTER: All applicants must have one (1) recommendation letter attached to
their application. Please submit a recommendation from any faculty or staff member at Century College or
I hereby certify that the information provided on this application form and is complete, accurate, and true to the
best of my knowledge.
Have you participated in the Leadership Institute before?