Leadership Award for Campus and Community Engagement

Please Note: this application requires attached documents. Please have the documents ready when you apply.

required denotes a required field.

Applicant Information First Name: required Last Name: required Title: required Department: required

Address: required Address 2: required City: required State: required Zip Code: required

Phone: required E-mail: required

College or University Information Institution: required President: required Phone: required E-mail: required

Attachments

Please submit all four required attachments. Attachments may be in any of the following formats: Acrobat PDF, Microsoft Word, Rich Text Format, Plain (ASCII) Text, or Tab separated text.

Reflective Essay required

Limit: 5 pages

Essay should describe the transformative impact of service, civic engagement and/or campus-community partnerships on your students, the community, your institution, and yourself; outline innovative programming you have created that has greatly affected the students, campus, and the community and with specific outcomes; and provide evidence of personal commitment to advancing civic engagement on campus, in the community, and within the field.

Letter of Support — Colleague required

Limit: 2 pages

This letter of support from a campus colleague (i.e. the president, a faculty member, or a staff member) should address as many of the selection criteria as possible.

Letter of Support — Community Partner required

Limit: 2 pages

This letter of support from a community partner should address as many of the selection criteria as possible.

Résumé required

Limit: 5 pages

Attach your resume or curriculum vitae.

Statement from student (optional)

Limit: 2 pages

Attach a reflective statement from a current or former student, addressing your work and its impact on her/him.

Supporting documentation (optional)

Limit: 5 pages

Documentation may include articles (newspaper, magazine, or journal), evaluation results, letters of appreciation, etc.

Additional Comments

If you have any comments or additional information that you wish to enter use the space provided here.

Comments:

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Leadership Award for Campus and Community Engagement Application