Grade

12

Entrance Leadership Awards 2012

Introduction

Instructions

To be eligible, you must be a high school student entering the first year of an undergraduate degree program at the U of A in September 2012, and have an awards average of 80% or higher on coursework competed at the time of application. Applicants must have also demonstrated exceptional leadership contributions to school and community in grades 10, 11 and 12. Its best to type your Activity Summary and Essay in a Word document that you can save. Once you are ready (dont forget to spellcheck and proofread), cut and paste the text into the appropriate pages of the PDF application.

1. Student Information
Complete the Student Information section. Applications must be typed. You can type in the Portable Document File (PDF) application on screen.

2. Activity Summary
In point form, provide information about your high school extracurricular and community leadership activities. List only those activities that have occurred within the last three years. Limit your comments to those activities in which you have had a leadership role. Do not include paid positions. Provide dates and estimated number of hours spent participating in each activity (e.g., 3 hrs per week, September 2009June 2010). Use only the space provided and DO NOT include extra pages.

3. Have your Activity Summary verified and signed by a reference or school official who can verify your activities. 4. Essay
In 300 words or less, describe what you have learned from your leadership experience. Essays containing more than 300 words will not be forwarded to the selection committee. Use only the space provided and DO NOT include extra pages.

5. Print, sign, and date your completed application. 6. Reference Letters (Two letters of reference are required)
Provide the Reference Instructions to your referees. Reference Form must be original, typed, dated, and signed by the author (the University of Alberta reserves the right to contact referees to verify the information submitted) To be accepted, the Academic Reference Form must include the students University ID, the referees contact information, and be signed by the author. Forms may be submitted: Directly by the referee by email (from a valid institutional or corporate e-mail domain only; public domain addresses such as Hotmail, Gmail, Yahoo, etc. cannot be accepted) to awards@ualberta.ca Directly by the referee or applicant by facsimile at 780-492-4851 By the applicant in hard copy form

7. Transcript
Alberta Students: You must include an up-to-date Alberta Learning course/mark inquiry with your application. Course/mark inquiries may be obtained from your high school counselling office. Non-Alberta Students: You must include an up-to-date high school transcript with your application. Transcripts/course/mark inquiries will only be accpeted by mail or in person.

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leadership awards application

Grade

12

Entrance Leadership Awards 2012

8. Submission

Instructions

A) Return all of the above directly by e-mail (from a valid institutional or corporate e-mail domain only; public domain addresses such as Hotmail, Gmail, Yahoo, etc. cannot be accepted) to awards@ualberta.ca or facsimile at 780-492-4851 by 11:59 p.m. MST, February 15, 2011. If sending via email, your application must be received by February 15, 2012 to the address below.

Note: Faxed, scanned, or e-mailed nomination packages must be original, typed, and signed by the author (the U of A reserves the right to verify any information received).
or B) Send original applications to: Entrance Leadership Awards Competition Student Awards Office 120 Administration Building University of Alberta Edmonton, AB T6G 2M7

9. No late applications will be accepted. Please keep a copy for your records.
It is your responsibility as the applicant to ensure your application is submitted complete and by the deadline.

Note: Failure to follow the application instructions will result in your application being deemed ineligible.

leadership awards application

Grade

12
Last Name

Entrance Leadership Awards 2012 Student Information

Your plans for University
Im interested in applying to the following Faculties/programs:
First Name Middle Initial (indicate top 3 choices)
1st 2nd 3rd choice

Personal Information
Mr Ms Mrs

(
Birthdate (mm/dd/yy)

)
Telephone

Agricultural, Life and Environmental Sciences Arts Augustana Business* Campus Saint-Jean Education Engineering Law Medicine and Dentistry* Native Studies Nursing Physical Education and Recreation Science

Mailing Address

City/Town, Province

Postal Code

Country

E-mail

(if known)

U of A ID number

Citizenship Status
Canadian Citizen: Alberta resident (if applicable) as of
month year

Canadian Permanent Resident

*Preprofessional year required.

Academic Information
Grade 10
School Name

Certain Leadership Scholarships require students to enter specific faculties/programs. If you plan to enter the following degree programs or majors, check the appropriate box(es). ( ) Biological Science (BSc) Bachelor of Arts in Recreation, Sport and Tourism

City/Town, Province

Telephone

Grade 11

School Name

Additional Information
( )
I have been involved in Junior Achievement or a similar organization. I have been involved in the YMCA or the YWCA (or a similar agency). I wish to be considered for awards for which financial need is a
Telephone

City/Town, Province

Grade 12

criterion.

School Name

Please indicate your estimations for the 20122013 academic year

(
City/Town, Province Telephone

(SeptemberApril):

Estimated Resources: $ ______________________ Estimated Expenses: $ ______________________

Country

High School Graduation Date:

month year

References Provided by
Name Ref 1: ________________________________________ Org: ______________________________________________ Name Ref 2: ________________________________________ Org: ______________________________________________

School Population: ___________________________________ School Composition: __________________________________ (e.g., Grades 10 to 12, 1 to 12, etc.)

leadership awards application

Entrance Leadership Awards 2012 Activity Summary

Position Held
e.g. captain

Applicant Name: _______________________________________

Activity/Group
name group/team and briefly describe your participation

Time Commitment
e.g., September 2009June 2010 approximately 3 hrs per week

Grade 10 Activities
Reference/School Official Verification: To be completed by Reference/School Official
Name (Printed) Position

Grade 11 Activities

Grade 12 Activities

(
E-mail Telephone

I confirm that I have read and can verify the activities listed on the Activity Summary.
Signature

Date

Grade

12

Entrance Leadership Awards 2012

Essay

Applicant Name (Printed): ________________________________________________ In order to properly evaluate your application, the selection committee would like to know more information about your leadership experience(s). Please answer the following questions in essay format drawing from your own experiences, using specific examples to describe your leadership activities and what you have learned from the experiences. Please keep statements to 300 words as extra pages will not be included for the selection committee. 1. What have you learned from your various leadership experiences?

2. What are your future academic and career goals and how have your leadership experience(s) influenced these plans?

Applicant Signature
I certify that the information contained in this application is complete and correct. I authorize Office of the Registrar to access my academic transcripts. I acknowledge that in order to be considered for Scholarships and Awards my academic transcripts and letters of reference will be provided to an award selection committee, who may contact my referees for the purpose of award selection. I further acknowledge that the Student Awards Office provides application information to academic and administrative units of the University of Alberta for the purpose of selecting and administering scholarships and awards. I am aware that the Student Awards office may use my name, program and award information in various publications, presentations, and announcements to promote the University and its award programs. Personal information on this form is collected under the authority of Section 33 (c) of Albertas Freedom of Information and Protection of Privacy Act for authorized purposes including admission and registration, scholarship and awards, student services, alumni relations and fund raising, and university planning and research. Students and alumnis personal information may be disclosed to academic and administrative units according to university policy, in accordance with federal and provincial reporting requirements; information sharing agreements with student governance associations, organizations and to contracted or public health care providers as required. For details on the use or disclosure of this information call the Registrar at (780) 492-3113 or see www.ipo.ualberta.ca.

X
Signature Printed Name Date

leadership awards application

Grade

12

Entrance Leadership Awards 2012 Reference Instructions

Students must provide two (and no more) letters of reference with your Leadership application. Employment related reference letters will not be considered. Provide the following instructions to your referees and ask them to return their reference letters to you in sealed envelopes or submit them directly to the Student Awards Office.

Instructions for Referees

You have been asked to provide a Letter of Reference for the University of Alberta Leadership Awards Competition. The Leadership Committee relies heavily on these letters in selecting recipients. Please be frank in describing why the applicant is worthy of such an award, focusing on his/her leadership qualities and activities, not academic acheivements. Applicants have until 11:59 p.m. MST, February 15, 2012 to apply, so be sure to submit your letter before this date. 1. Reference letters should be original, typed, signed by the author, and dated. The following information should appear in your letter: Name of applicant and student ID number Your contact information Your occupation/position Your place of work Your relationship to applicant (how you know him/her) Length of time you have known the applicant Why the applicant is worthy of such an award, focusing on his/her leadership qualities and activities, not academic achievements. Signature Incomplete reference letters will disqualify the student. 2. Reference letters may be submitted: Directly by the referee by email (from a valid institutional or corporate e-mail domain only; public domain addresses such as Hotmail, Gmail, Yahoo, etc. cannot be accepted) to awards@ualberta.ca Directly by the referee or applicant by facsimile at 780-492-4851 By the applicant in hard copy form

If you have questions, please contact the Student Awards Office at 780-492-3221 or awards@ualberta.ca.

leadership awards application