Future Leaders Conference Survey
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Future Safety Leaders Conference (FSLC) Attendee Selection Worksheet
ASSE and the FSLC Conference Committee will limit the number of attendees. Only select students who meet the requirements, based on their application essay and faculty advisor’s recommendations will be invited to attend. This will allow the conference to maintain continuity, more efficiently utilize sponsorship dollars, and deliver a better product for the attendees.
Invitations will be extended to each Student Section President and Vice President. The remaining attendees will be selected based upon criteria outlined below, the recommendations of their respective Faculty Advisor and a short essay prepared and submitted to Faculty Advisors by student candidates.
FACULTY ADVISORS: In order for your students to be eligible to attend the 2015 FSLC, please complete this Student Attendee Selection Worksheet and return, along with each student’s completed Essay Worksheet, to [email protected] NO LATER THAN SEPTEMBER 18, 2015.
STUDENTS: All students, including the invited section president and vice president, wishing to attend the conference are required to submit a short Essay Worksheet to their Faculty Advisor NO LATER THAN SEPTEMBER 11, 2015. Your Advisor will send the Essay Worksheet along with this Attendee Selection Worksheet to the FSLC Task Force for consideration of invitation to the FSLC. The essay questions are to be completed on a separate form found on h ttp://www.asse.org/membership/student_fslc/.
If you have any questions related to the process, please contact Chapter Services at [email protected].
College or University: ______
Total Number of Students enrolled in a Safety, Health or Environmental related major: ______
Total number of ASSE Student Section Members: ______
Officers (PLEASE ONLY LIST IF THEY PLAN TO ATTEND THE CONFERENCE) Student Section President Student Section Vice President
Name : Name:
E-mail: E-mail:
Membership Membership ID: ID:
The remaining students will be selected based on a combination of factors including, but not limited to: academic performance, class standing, student section membership and participation, and faculty advisor ranking.
Please rank each student nominee. Faculty Advisors may choose to use the Ranking Rubric Tool, which can be found on http://www.asse.org/membership/student_fslc/.
1 Future Safety Leaders Conference (FSLC) Attendee Selection Worksheet
Student Nominee Has Class Active Student ASSE Overall GPA previously Standing Member: Y/N 3.0 or attended this (JR, SR, or Provide Membership higher conference Grad) # Name: Y/N
Email:
Ranking: _____
Has Class Active Student ASSE Overall GPA previously Standing Member: Y/N 3.0 or attended this (JR, SR, or Provide Membership higher conference Grad) # Name: Y/N
Email:
Ranking: _____
Has Class Active Student ASSE Overall GPA previously Standing Member: Y/N 3.0 or attended this (JR, SR, or Provide Membership higher conference Grad) # Name: Y/N
Email:
Ranking: _____
Has Class Active Student ASSE Overall GPA previously Standing Member: Y/N 3.0 or attended this (JR, SR, or Provide Membership higher conference Grad) # Name: Y/N
Email:
Ranking: _____
2 Future Safety Leaders Conference (FSLC) Attendee Selection Worksheet
Has Class Active Student ASSE Overall GPA previously Standing Member: Y/N 3.0 or attended this (JR, SR, or Provide Membership higher conference Grad) # Name: Y/N
Email:
Ranking: _____
Has Class Active Student ASSE Overall GPA previously Standing Member: Y/N 3.0 or attended this (JR, SR, or Provide Membership higher conference Grad) # Name: Y/N
Email:
Ranking: _____
Has Class Active Student ASSE Overall GPA previously Standing Member: Y/N 3.0 or attended this (JR, SR, or Provide Membership higher conference Grad) # Name: Y/N
Email:
Ranking: _____
Has Class Active Student ASSE Overall GPA previously Standing Member: Y/N 3.0 or attended this (JR, SR, or Provide Membership higher conference Grad) # Name: Y/N
Email:
Ranking: _____
3 Future Safety Leaders Conference (FSLC) Attendee Selection Worksheet
Has Class Active Student ASSE Overall GPA previously Standing Member: Y/N 3.0 or attended this (JR, SR, or Provide Membership higher conference Grad) # Name: Y/N
Email:
Ranking: _____
Has Class Active Student ASSE Overall GPA previously Standing Member: Y/N 3.0 or attended this (JR, SR, or Provide Membership higher conference Grad) # Name: Y/N
Email:
Ranking: _____
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