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Application Form

Application Form

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Published by: ernestobneri on Mar 24, 2010
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07/10/2013

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Xavier University – Ateneo de Cagayan Central Student Government 2010-2011Part A. STUDENTINFORMATIONRead before answering.
Fill in
ALL
pertinent fields provided. Spell outacronyms. Do not use pencil.Complete Name (Given Name, Middle Name, Family Name)Nickname:Age:Sex:
Male
FemaleBirthday ( month, date, year)Religion:Position applied:Course and Year level:High School Attended:Year graduated from High School
Residence and Contact Details
Home Number/s:Fax Number:Mobile Number/s:Home Address:City Address:Zip Code:Email Address:
Person/s to Contact in Case of Emergency
 Name:Relation to applicant:Contact number/s
Quick Questions:
Why do you want to apply for CSG? ( 100words max)What for you is a servant-leader? ( 100 wordsmax)
 
XAVIER UNIVERSITY – ATENEO DE CAGAYAN
CENTRAL STUDENT GOVERNMENT
Rm 201, 2
nd
Flr., Student Center Building (STC), TEL No. 8583116/723116Xavier University, Corrales Avenue, CDO local 3305
 
Part B. LEADERSHIPBACKGROUND
Read before answering.
List down five (5) most significant leadership responsibilities thatyou have held within the past three years. These may be leadership roles in your school,socio-civic, church, political or local community organizations.
Rank 
these according tosignificance with one (1) ranked as the
most significant for you.
Only one (1) leadershiprole/university per number. Answer all the questions that follow. Spell out acronyms.
Leadership Role/ Responsibility,YearName of OrganizationBrief description of role/responsibility and itssignificance to its constituents/ members/community.
 Ex.President, 2008-2009Teachers GuilThe highest position of the executive body in the Teacher’sGuild which implements programs/activities for the welfareof the School of Education.
1
Scope of Leadership Role/Responsibility:
I work with/ handle a small group of people ( less than 15)I work with/ handle a medium sized group of people ( 16-30 people)I work with/ handle a large group of people ( around 31-50 people)I work with/ handle a very large group of people ( more than 50 people)
Consistency and reach of organization:
Organization wide/ Batch wideUniversity / College wide
Local / Community-based ( barangay, village, town, city) Nationwide
How did you attain the role/responsibility?
I was electedI applied/appointed
Automatic/Ex-officio
If you were elected, who voted during the election?
All the members/ constituents of the organizationOnly selected members / members of the committeeOnly officers/ core group/ EXECOMFaculty/ School AdministratorsOthers, please specify .
If you were appointed, who appointed the role to you?
President / Head / EXECOM / Core of the organizationOther Officers / Team Leader / Project HeadPeers / Co-members in the group or organizationFaculty / School Administrators / ModeratorsOthers, please specify .
How long have you been with the group/organization?
less than 1 year 
1-2years
3 years or more
Summarize what you have accomplished in this leadership role. ( 4 sentences )Leadership Role/ Responsibility,YearName of OrganizationBrief description of role/responsibility and itssignificance to its constituents/ members/community.
2
Scope of Leadership Role/Responsibility:
I work with/ handle a small group of people ( less than 15)I work with/ handle a medium sized group of people ( 16-30 people)I work with/ handle a large group of people ( around 31-50 people)I work with/ handle a very large group of people ( more than 50 people)
Consistency and reach of organization:
Organization wide/ Batch wideUniversity / College wide
Local / Community-based ( barangay, village, town, city) Nationwide
How did you attain the role/responsibility?
I was electedI applied/appointed
Automatic/Ex-officio
If you were elected, who voted during the election?
All the members/ constituents of the organizationOnly selected members / members of the committeeOnly officers/ core group/ EXECOMFaculty/ School AdministratorsOthers, please specify .
If you were appointed, who appointed the role to you?
President / Head / EXECOM / Core of the organizationOther Officers / Team Leader / Project HeadPeers / Co-members in the group or organizationFaculty / School Administrators / ModeratorsOthers, please specify .
How long have you been with the group/organization?
less than 1 year 
1-2years
3 years or more
Summarize what you have accomplished in this leadership role. ( 4 sentences )
 
Xavier University – Ateneo de Cagayan Central Student Government 2010-2011

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