Rural Business Leadership Initiative Application
Chadron State College
Directions: Please read before completing. The application is a fillable form that must be downloaded to
your computer for completion. Upon completion, save the application and submit it along with supporting
documentation to rbli@csc.edu. Handwritten applications will be disqualified. Your CSC Admissions
application should already be submitted prior to completion of this application.
Submission Deadline is January 31, 2021.
Address: City: State: Zip:
Phone: Email:
Birth Date:
High School Information:
Name of School:
Year of Graduation:
Address: City: State: Zip:
Last Name: First Name: MI:
Student Contact Information:
Currently Enrolled? Yes No
If Yes, NUID:
If a current student, year in school: Freshman Sophomore Junior Senior
Resume:
Upload your professional resume. Your resume must include:
GPA & ACT/SAT Scores:
Current GPA:
Enrollment Status:
ACT/SAT Score:
High School Chadron State College Transfer School, School Name:
Career Objectives/Goals
Education History
Employment History (include hours worked per week
Special Accomplishments (honors/awards/offices held)
Community Service/Civic Engagement
