Chancellor's Leadership Program
Application for Participation starting Spring 2007

Last name     
First name     
Middle name 

Phone number 
Cell number 
Email address 

Permanent mailing address (include city, state and zip )

Date of Birth 
Gender 

Ethnicity (optional)

Do you anticipate graduating from TCU? 
Anticipated college major 
High School GPA 

Please give the name of any previous colleges or universities attended, credits earned, and completion dates.
 

Please list activities you were involved with since attending TCU and while in high school years, along with the number of years of involvement.  (Include work, travel, honors, fine arts, athletics, community, volunteer, religious and academic groups, etc.)
 

Please write a 250-300 word essay explaining your definition of leadership.
 

Please describe a social issue about which you feel passionate and describe what you can do to affect change as it relates to this issue.  The issue can be, but is not limited to, one impacting your school, your local community, your state or nation, or a specific population.
 

By submission of this application, I hereby acknowledge that the information contained in the preceding pages is correct to the best of my knowledge.  I hereby authorize TCU to release appropriate profile information to donors and the media, and to include it in campus publications.  This information may include my name, hometown and state, degree program, major and academic status (e.g., freshman, sophomore, junior, senior, or graduate.)