Fill - Free fillable Student Ambassador Application (Folsom Lake College) PDF form

Student Ambassador Application

APPLICANT INFORMATION______________________________________________________________

Name: ________________________________ Student ID #: _________________________

Address: ____________________________________________________________________________

City: _______________________________________ State: ___________ Zip Code: ________________

Preferred Phone: _______________________ E-mail Address: _________________________________

What languages other than English do you speak fluently? ____________________________________

EDUCATION RECORD__________________________________________________________________

Last High School Attended: ____________________________________ Year of Graduation: _________

If you have attended other colleges/universities, please list them below:

College/University

Location

Years Attended

Degree Attained

First Semester at FLC: _________________ Expected Graduation/Transfer Date: __________________

Units Completed at FLC: ___________ Cumulative G.P.A. at FLC: ___________

FLC Major & Educational Goal: ___________________________________________________________

EMPLOYMENT HISTORY AND REFERENCES_________________________________________________

Most Recent Employment: ______________________________ Job Type: _______________________

Please list two references.

Name

Organization/Company

Title

Phone #

QUESTIONS______________________________________________________________

Please type your answers to the questions below:

In a brief essay, state why you would like to serve as a Folsom Lake College Student Ambassador.

Include any qualities you possess that would qualify you to be a successful Student Ambassador.

What are your future plans and long-term career goals? How does being an Ambassador fit into these goals?

Please list any extra-curricular activities, clubs, and organizations that you are involved with.

College and High School Activities:

Community Involvement:

Hobbies:

How will you utilize your collegiate experiences to mentor Summer Bridge and First Year Experience

participants?

Consent for Verification of Student Records:

I hereby certify that all statements made on this application are true and correct to the best of my knowledge and authorize investigation

of all statements herein recorded. I release from all liability persons and organizations reporting information required by this application.

I grant permission to an authorized representative of Folsom Lake College to verify my student records for purpose of this application.

Signature: __________________________________________________ Date: ____________________

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