Student Affairs Award Application

Student Affairs Award Application Spring 2017

Student Name: ______

Student ID Number: ______Earned Credits : ______SCSU E-mail Address: Cumulative GPA:______Phone Number: ______# of Semesters Completed at SCSU: ______

Please read through the criteria for each of the awards below. Then select the awards in which you are applying for. Note: You may select more than one award. Outstanding Underclassmen Awards:

OUTSTANDING FRESHMAN AWARD: For a freshman student who shows outstanding commitment and success in the areas of scholarship, leadership, and service. (0-30 Credits)

OUTSTANDING SOPHOMORE AWARD: For a sophomore student who shows outstanding commitment and success in the areas of scholarship, leadership, and service. (31-60 Credits)

OUTSTANDING JUNIOR AWARD: For a junior student who shows outstanding commitment and success in the areas of scholarship, leadership, and service. (61-90 Credits)

Senior Awards:

PRESIDENT’S AWARD* – For the student who represents the values and mission of Southern Connecticut State University through an exemplary record of scholarship, leadership and service to the institution. UNIVERSITY LEADERSHIP AWARD* – For the honest, forward-thinking, inspiring, and competent student with a demonstrated record of involvement in University-sponsored events and activities.

UNIVERSITY SERVICE AWARD* – For the student who has performed acts of courage, vision, dedication, and tenacity that have had a measurable impact on the University and the local community.

*Senior Awards are open to any undergraduate student who is eligible for graduation in May 2017 or December 2017

Please send the completed application form to the Assistant Vice President and Dean of Students Office, EN A106 by March 1, 2017. Please complete the questions on page 2. Attach additional sheets if necessary

1. Please list all relevant co-curricular activities and other contributions to Southern Connecticut State University. Provide dates when possible.

2. Please explain how your participation has benefited your personal growth and development and advanced the mission of student life at Southern Connecticut State University.

3. Explain why you are a deserving recipient by commenting specifically on the award criteria provided.

Please return the completed nomination form to the Assistant Vice President and Dean of Students Office, EN A106 by March 1, 2017. Signature: ______Date: ______

Please return the completed nomination form to the Assistant Vice President and Dean of Students Office, EN A106 by March 1, 2017.