2011 - 2012 Leader of the Year Application |
Personal Data |
| College: |
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| First Name: |
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| Middle Name: |
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| Last Name: |
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| Name initiated under, if different from above: |
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| Home Address: |
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| City |
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| State |
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| Zip Code |
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| Permanent Phone: |
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| Date of Birth: |
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| E-mail address: |
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| Name of Parent or Guardian: |
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| Parent's Address: |
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| City |
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| State |
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| Zip Code |
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Local Media |
| Hometown Newspaper Name: |
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| Hometown Newspaper Address: |
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| Hometown Newspaper City: |
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| Hometown Newspaper State: |
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| Hometown Newspaper Zip: |
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| School Newspaper Name: |
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| School Newspaper Address: |
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| School Newspaper City: |
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| School Newspaper State: |
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| School Newspaper Zip: |
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College/University Information |
| Course being pursued (e.g., Arts and Sciences, Education, Business): |
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| Major Subject: |
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| Minor Subject: |
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| GPA: |
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| Are you an active member of Omicron Delta Kappa: |
Yes
No
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Extracurricular Activities |
| Describe the ways in which you have been active in your Circle. Include Circle offices held. |
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| List all other major activities or accomplishments during your years of college attendance. Indicate any office held opposite each activity. |
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Recommendations: |
| List the names of two people you are asking to write on your behalf. |
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| For the rest of the needed materials please upload files (Documents, PDF, or picture files) using the upload tool below. You will need to include: |
- A cover letter or personal statement reflecting your vocational objectives.
- A 1-2 page resume or vitae that includes a list of your involvement in Honor Societies, Student Organizations, and Community Involvement.
- No more than three letters of recommendation (we recommend at least one (1) academic reference and (1) leadership reference.
- A copy of your Final Transcripts
- A formal picture
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| Uploaded files: |
| No files uploaded |
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Important: |
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Applications are due on March 15, 2012.
It is necessary that nominees comply with all of the requirements for the award. If you have questions regarding this form, please
contact the National Headquarters at awards@odk.org.
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