Leadership Application

Application for Admission to the 2008 Leadership Academy

Personal Information

Name (First/ MI / Last):

Social Security # (xxx-xx-xxxx):

School:

Chapter:

Year in School:

Choose One Freshman Sophomore Junior Senior

Expected Year of Graduation:

Choose One 2008 2009 2010 2011 2012 2013

Shirt Size:

Choose One M L XL XXL

Preferred Name:

Current Contact Information

Mailing Address:

City, State, Postal Code:

E-Mail Address:

Phone (xxx-xxx-xxxx):

Cell Phone (xxx-xxx-xxxx):

Summer Contact Information

Effective Date (MM/DD/YEAR):

Mailing Address:

City, State, Postal Code:

E-mail Address:

Phone (xxx-xxx-xxxx):

Emergency Contact Information

Name:

Relationship:

Phone (xxx-xxx-xxxx):

Academic Information

Major Field of Study:

College Subjects Of Greatest Interest:

Cumulative GPA:

Based on a  Point System

In order of importance to you, please list ALL college honors, awards and areas in which you have distinguished yourself:

In order of importance to you, please list ALL college offices or positions held, as well as how the experience(s) has/have contributed to your leadership skills:

Please list any hobbies and recreational interests you may have:

Essay Questions

Note: Type essay answers in a word processor, save and spell check, then copy and paste into the boxes below.

In 250 words or less, thoroughly describe why you want to be a part of the Leadership Academy:

In 250 words or less, thoroughly describe how your membership in Delta Tau Delta has prepared you for future leadership roles:

In 250 words or less, clearly state what the expression "Life is my college. May I graduate well and earn some honors!" means to you:

Academy Preference

First Choice:

No Peference Sailing Leadership Academy (Summer 2008, dates TBA) Capital Leadership Academy (March 13-17, 2008) Bethany Leadership Academy (Summer 2008, dates TBA)

Second Choice:

No Peference Sailing Leadership Academy (Summer 2008, dates TBA) Capital Leadership Academy (March 13-17, 2008) Bethany Leadership Academy (Summer 2008, dates TBA)

Academy Expectation Agreement

By submitting this application, I am affirming that the information contained herein is truthful and accurate. I understand that the Delta Tau Delta Leadership Academy is a substance-free program, and I agree not to bring, use, nor consume alcohol or other drugs during the program's entirety. I further agree to participate in all Leadership Academy activities and remain on the host location for the duration of the Academy. I will challenge myself and other participants to abide by these expectations and will confront those who violate them. I further understand that violation of these expectations will result in my immediate dismissal from the Leadership Academy and the host property. Furthermore, I understand that a non-refundable monetary deposit is required to confirm my selection to attend an Academy if an offer to attend has been extended.