Fillable PLC App Online- App - Fall-2019 (Connors State College)

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PLC App Online- App - Fall-2019 (Connors State College)

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The PLC App Online- App - Fall-2019 (Connors State College) form is 5 pages long and contains:

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(Applicant’s Name)
Checklist:
Apply to, and be accepted by, Connors State College before March 1st
Your applicaon is considered incomplete without all of the required documents listed in the checklist below. An
incomplete application will not be considered. Using a BINDER CLIP, please attach all the required elements of the
application portfolio in the order shown in the checklist below. Please do not staple and please do not place the
application in a folder, binder, or notebook.
1. Completed PLC Regents Tuion Waiver Scholarship Applicaon
2. Sealed envelope with your ocial, 7 or 8 semester high school transcript enclosed
3. Ocial ACT Scoresheet portraying the ACT trademark (Required only if the ACT score is not included on HS Transcript)
4. Typewrien resume lisng awards, acvies, honors, leadership posions & community service hours
5. Typed essay that describes what most disnguishes you as an individual (Please limit your response to 100 words)
6. Three sealed envelopes with one leer of recommendaon enclosed within each
7. Sealed enve
lope, from each college you have aended, with an ocial college transcript enclosed (If applicable)
Submit your applicaon porolio to:
Connors State College, Vice President for Academic Affairs, 218 Gatlin Hall, 700 College Road, Warner, OK 74469
Regent’s Scholarships are awarded only to Oklahoma residents
1
Deadline - March 1st
2
APPLICANT INFORMATION
PLC REGENTS TUITION WAIVER SCHOLARSHIP
APPLICATION DEADLINE: March 1st
Please resp
ond to each queson below:
Are you an Oklahoma Resident ? Yes No
Have you completed any college – level courses? Yes
No
List Colleges aended (If Applicable): _________________________________________________________________________
College GPA (If Applicable): ___________________________________
College Classification (incoming at CSC next fall): Freshman Sophomore
Are you planning on being a member of any CSC competitive teams or organizations next year? Yes No
If yes, please list the CSC teams or organizaons that you plan to join. _______________________________________________
_____________________________________________________________________________________________
Applicant Signature Applicaon Date
Last Name: First Name: Middle Name:
Street Address:
OKLAHOMA
Zip Code: City:
Home Phone: Cell Phone:
E-Mail Address: (please print clearly)
Date of Birth (MM-DD-YYYY):
Age:
Current High School: City: Current High School Address:
Counselor Contact Number: HS Counselor E-Mail Address: HS Counselor:
ACT English
Sub Score
ACT Math
Sub Score
ACT Reading
Sub Score
ACT Science
Sub Score
ACT
Composite
Class Rank
Unweighted
GPA
Gender:
High School Informaon Secon Below MUST be completed by High School Counselor:
High School Counselor’s Signature: _______________________________________________________________________
3
Acvity Informaon
School Organizaons and Clubs
Community Organizaons/Service
Acvity Name Posions Held 9th grade
hours per
week
10th grade
hours per
week
11th grade
hours per
week
12th grade
hours per
week
Signicant Contribuons
or Honors Received
Academic Honors (i.e. Naonal Honor Society, Who’s Who Among American High School Students, etc.)
Grade Levels of
Parcipaon
Honor/Award Title Descripon of Award
Leers of Reference (Leers of Recommendaon)
PLC applicants must provide three letters of reference. Please copy pages 4 & 5 and give one copy to each associate providing a
referral. Please ask each associate to prepare a letter of recommendation for you based on the instructions in the letter.
They should return the letter to you in a sealed envelope. Please BINDER-CLIP the three, sealed envelopes with your application
portfolio.
Acvity Name Posions Held 9th grade
hours per
week
10th grade
hours per
week
11th grade
hours per
week
12th grade
hours per
week
Signicant Contribuons
or Honors Received
Aer you complete this page, please make a copy of it for your les.
4
___________________________________________________________________
Applicant’s Name
PRESIDENT’S LEADERSHIP CLASS
(Recommendaon Instrucon Sheet for Referring Associates)
Dear Referrin
g Associate,
Admission to the President’s Leadership Class (PLC) is one of Connors State College’s top honors. The President’s Leadership Class
involves scholarship, leadership, and service. PLC students are considered an extension of the Connors State College President. The PLC
is both an academic class and a student acvies organizaon. PLC members will have the opportunity to develop leadership skills
through course work and PLC acvies. Connors State College’s President, faculty, and sta will ulize the group to promote qualies of
scholarship, leadership, and service as ambassadors on CSC campuses, in the community, and at state-wide events.
Due to PLC’s unique structure, we require qualicaons not usually covered in a typical leer of recommendaon. PLC accepts
only applicants who are skilled in the following areas: intellectual curiosity, leadership potenal, commitment outside self and
unique contribuon. We already have copies of the applicant’s grades and test scores, so it is not necessary to menon those
items unless you do not feel they accurately represent the student.
As you write a leer of recommendaon, please consider our selecon criteria listed above and the following qualies that we
look for in our scholars:
● Takes the iniave to pursue opportunies outside the classroom
● Is open to other people’s values that are dierent than his/her own
● Exhibits mental toughness under stress
● Demonstrates empathy when interacng with others
● Has a background that will provide a unique perspecve among other top students
We thank you for taking the time to write a letter on your student’s behalf so that we can best understand his/her potential for
success in our program. Please remember that our application portfolio deadline is March 1 and we MUST have ALL of the
completed application portfolios in our office by that day. Please return your letter to the student in a sealed envelope and
include the Recommendation Form (see page 5) in the envelope as well. Please return the sealed envelope to the student, with
the Recommendation form and your letter of recommendation enclosed, so that he/she may submit the letter and the application
portfolio to our offices by the deadline of March 1.
If you have any questions or problems, please do not hesitate to contact the Office of Vice President for Academic and
Student Affairs (918) 463-6308.
Best Regards,
Dr. Ron Ramming
President, Connors State College
Applicant,
please make 3 copies of this page and page 5. Give a copy of page 4 and of page 5 to each of your
referring associates for your applicaon porolio. Also, please make a copy for your les.
PRESIDENT’S LEADERSHIP CLASS
Recommendaon Form
IMPO
RTANT PRIVACY NOTICE: Under the terms of the Family Educaon Rights and Privacy Act (FERPA), students who matriculate into
the program to which they apply are given the right to inspect their records, including their leers of recommendaon, unless they
have waived their right to review. You have the opon of signing the following waiver or declining to do so.
_
________I expressly waive any rights I might have to access this leer of recommendaon under the Family Educaonal Rights and
Privacy Act of 1974.
_________I do not agree to the waiver above.
Student Signature______________________________________________________ Date___________________________
_
__________________________________________________________________________________________________________
Name
_
__________________________________________________________________________________________________________
Title Organizaon
___________________________________________________________________________________________________________
Phone Number E-Mail
___________________________________________________________________________________________________________
Referring Associate Signature Date
Please include this Recommendaon Form in the same envelope with your leer of recommendaon.
5
TO THE APPLICANT: (Complete this poron before giving to your associates wring recommendaon leers):
REFFERING ASSOCIATE’S CONTACT INFORMATION :
Applicant, please make 3 copies of this page and page 4 to give to your referring
associates. Also, please make a copy for your les.
APPLICATION DEADLINE IS March 1
President’s Leadership Class Applicaon Requirements
1. Apply to, and be accepted by, Connors State College before Oct. 1st
2. Complete the PLC Regents Tuition Waiver Scholarship Application
3. Submit a sealed envelope with your official, 7 or 8 semester high school
transcript enclosed
4. Provide an official ACT Scoresheet portraying the ACT trademark
(Required only if the ACT score is not included on HS Transcript)
5. Provide a typewritten resume listing awards, activities, honors, leader-
ship positions & community service hours
6. Provide a typed essay that describes what most distinguishes you as an
individual (Please limit your response to 100 words)
7. Include three sealed envelopes with one letter of recommendation
enclosed within each
8. Submit a sealed envelope, from each college you have attended, with
an official college transcript enclosed (If applicable)
Selecon Process—President’s Leadership Class
All applicants who meet the specied requirements will be considered by the PLC Selecon Commiee. All applicants will receive ranking scores based on
three elements: ACT composite and sub-scores, the information provided in the PLC application packet, and the interview. The three ranking scores for
each applicant will be averaged to determine each final ranking score and the final applicant ranking. Interviews will held in March.
Selected students must return the accompanying award agreement form to the scholarship office within one week of receiving the scholarship offer. The
student must complete registration forms by the second week of May.
The President reserves the opon of special appointment.
6
Effective September 2018
President’s Leadership Class (PLC) Course & Scholarship Descripons
PLC members will enroll in four semesters of consecuve PLC classes. PLC Course Descripon:
PSYC 2311, PSYC 2321, PSYC 2331, and PSYC 2341 – President’s Leadership Class 1 Credit/Semester
Prerequisites: Preference will be given to PLC applicants who are proficient in English (Writing), Reading, Math, and Science. PLC applicants must
submit an application portfolio and be selected by the PLC Selection Committee. The CSC President reserves the option of special appointment.
The President’s Leadership Class involves scholarship, leadership, and service. PLC students are considered an extension of the Connors State
College President. The PLC is both an academic class and a student activities organization. PLC students will have the opportunity to develop
leadership skills through course work and PLC activities. Connors State College’s President, faculty, and staff will utilize the group to promote
qualities of scholarship, leadership, and service as ambassadors on CSC campuses, in the community, and at state-wide events. PLC students must
earn an “A” in PLC class and complete 12 credit hours each semester with a cumulative GPA of 3.0 with no grade below a “C”, “P”, or “S”.
PLC Regents Tuion Waiver Scholarship Descripon:
The PLC membership and scholarship (tuion waiver) is available on a semester-by-semester basis for up to four consecuve fall and spring semes-
ters. The tuion waiver covers a maximum enrollment of 18 credit hours per semester and does NOT include fees, books, room, or board. PLC
membership includes 10 hours/week college work. Each student will work 4 hours/week in service to PLC/CSC and 6 hours/week for a work supervi-
sor on campus.
PLC Scholarship Renewability Requirements
The PLC membership, as well as the scholarship award, will be renewed for
up to 4 consecuve semesters if the member complies with the following:
1. Earn an “A” in PLC class (see course descripon above)
2.
Maintain a cumulative 3.0 GPA with no grade below a “C”, “P,” or “S”
3. Successfully complete 12 credit hours per fall and spring semester
4. Developmental courses (zero level) must be passed with an “S” within
the rst 24 aempted hours
5. Receive posive behavior and performance reports from their instruc-
tors, work supervisors, the Dean of Students
6. Acvely parcipate in ocial CSC student acvity funcons on campus
7.
No probaonary period will be oered. Students who do not meet
the renewal requirements will not be allowed to connue in the PLC.
Submit your application portfolio to: Connors State College, Office of Vice President for Academic and Student Affairs, Gatlin Hall,
700 College Road, Warner, OK 74469
*PLC students will be required to participate in the random drug-testing program at CSC.
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PLC App Online- App - Fall-2019 (Connors State College)

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Completed 26 July 2020

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