Fill - Free fillable ServiceScholarProgram Application CivicEngagement,CriticalReflection,Scholarship (Owens Community College) PDF form

ServiceScholarProgram

Application

CivicEngagement,CriticalReflection,Scholarship

Name:________________________________________

_____OCID:_____________________

Today’sDate:___________________AnticipatedgraduationdateatOCC:________________

Address:_________________________________City,State&ZipCode:__________________

PrimaryE‐mail:________________________________________________________________

Phone:(home)_____________________(cell)_________________(other)_________________

Intendedmajor/fieldofstudy:_____________________________________________________

Applicationprocess:

Applicationsareacceptedonarollingbasis.AfteraCCCC(Center for Campus and Community

Connections)representativeacceptsyourapplication,youwillbeabletostartparticipating

immediately.Toqualifyyoumustbeabletodemonstrateasubstantiallevelofinvolvementin

communityservicerelatedtoyourcourseofstudy.Thisvariesfromdepartmentbutshouldinclude

atleast40cumulativehoursofserviceatoneormorecommunitypartnerorganizations.A

cumulative2.5GPAisrequiredtoberecognizedatgraduationasaServiceScholar.IfyouGPAis

currentlylower,youcanstillapply,youwillhaveaonesemestergraceperiodtobringyourGPAto

2.5.

PLEASEREADCAREFULLY

IhavereviewedandunderstandtherequirementsfortheServiceScholarprogram.I

understanditismyresponsibilitytocompletealltherequirementsandtoturninallrequired

formsdocumentingmyprogressintheprogram.IalsounderstandthatIwillbeplacedon

probationarystatusforonesemesterifIdon’tmeettheserequirements;afteronesemester

withnocontact,IwillbedroppedfromtheServiceScholarsprogram.Iwillpromptlyreportany

changeinmycontactinformation,chosenmajoranddateofgraduationtotheprogram

coordinator.

Toapply,pleasesubmitthefollowing:

a) Acompletedandsignedapplicationform

b) Responsestothequestionsonthebottomofthisapplication

c) Acurrentcopyofyourtranscript(canbeunofficial)

_______

____________________________________________________________

SignatureofServiceScholar Date

___________________________________________________________________

SignatureofServiceScholarProgramAdministrator Date

Pleaseanswerthefollowingquestions.Typeyourresponsesanddeliverinpersonoremailto

theCCCC(CollegeHall155).

1. WhyareyouinterestedintheServiceScholarprogram?

2. Whatcommunityissueareyoumostpassionateaboutaddressingwhileinthisprogram?

a. Whyareyoupassionateaboutthisissueandhowdoesitrelatetoyourcourseofstudy?

b. HowdoyouhopetoaddressorhowhaveyouaddressedthisissueasaService

Scholar?(documentationofparticipationwillberequired.)

3. Inwhatway(s)doyouhopetobechallengedasaServiceScholar?Howdoyouhopetogrowas

apersonasaresultofthechallenge(s)?

ServiceScholarswillbeinvitedtoparticipateintheSpringHonors/ServiceSymposium.Accepted

studentswillsharea20minutepresentation,sharingtheserviceprojectasitrelatestothecourse

ofstudyidentified.

ServiceScholarswillalsobeid

entifiedinthecommenc

ementBookletatgraduationandwillbe

identifiedatcommencement.(detailstofollow)

Additionally,ServiceScholarswillbeinvitedtotheHonorsBreakfasttoberecognizedwiththeir

facultyandbythePresidentoftheCollege.

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ServiceScholarProgram Application CivicEngagement,CriticalReflection,Scholarship (Owens Community College)

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