ADLAI E. STEVENSON
      HIGH SCHOOL
                  STUDENT
                 LEADERSHIP
                  ACADEMY

  APPLICATION PACKET

    Meeting Times: Tuesday mornings from 7:30 - 8:30 a.m.


     * If interested, complete the attached application form
    and return to the Student Activities office (Room #1102).



       “It is time for a new generation of leadership to cope with the
        new challenges and opportunities of our world. For those
                to whom much is given, much is also required.”



 Submit application to Mr. Goergen (Room #1102)
NO LATER THAN Wednesday, September 7th, 2011.
Sla student application
Application for enrollment
                         Student Leadership Academy


NAME: _______________________________________________                ID: _______________________

ORGANIZATION/CLUB: _______________________________                   LUNCH PERIOD: __________

EMAIL: ______________________________________________

ARE YOU REQUIRED TO TAKE SLA?                   YES             NO

1.   Define Leadership




2.   I consider myself a leader at __________________ because




3.   I don’t consider myself a leader at _________________ because




4.   When you think of yourself as a leader, what expectations do you have of yourself?
5.    What expectations do you feel others have of you as a leader?




6.    Leaders create positive change. What have you done to make a positive change in your world? Or,
      What would you like to do?




7.    What most interests you about Student Leadership Academy? What do you hope to gain from the
      experience?




8.    In what way do you plan to use the learning and experiences you receive from taking this course?




Please return completed form to Mr. Goergen in the Student Activities office (Room 1102) no later
than Wednesday, September 7th, 2011.
Faculty/Staff Recommendation
                                       for enrollment in the
                                   Student Leadership Academy

To the applicant: Please complete the first part of this form and give it to a faculty/staff member who has
taught you, been your sponsor or coach.

Name: _______________________________________                                                  ID: __________________


To the recommender: The applicant named above is applying for enrollment in Stevenson’s Student
Leadership Academy. Space is limited to 10 students per lunch period so close attention is paid to the
faculty/staff recommendation. Your candid evaluation of this applicant’s leadership abilities and potential
for success is greatly appreciated. Please include any information about the applicant’s social or academic
background or emotional makeup that should be considered, including character factors. Your input is
greatly appreciated.

Please use the table below to compare the applicant with other students in his/her class, activity or sport
No basis for                                   Below                     Very      Unusually                    Truly
                                                           Average                             Outstanding
judgement                                     Average                    Good        Good                     Exceptional
                 Academic performance
                 Independent thinking
                 Quality of participation
                 Writing ability
                 Motivation
                 Judgement and maturity
                 Leadership ability
                 Cooperation with others

Recommendation (use reverse side if necessary):




How long, in what connection, and how well have you known the applicant?
__________________________________________________________________________________________
__________________________________________________________________________________________

Name: _______________________________                                                          Date: __________

               Please return recommendation to Ted Goergen in Student Activities by Wednesday, September 7, 2011.

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Sla student application

  • 1. ADLAI E. STEVENSON HIGH SCHOOL STUDENT LEADERSHIP ACADEMY APPLICATION PACKET Meeting Times: Tuesday mornings from 7:30 - 8:30 a.m. * If interested, complete the attached application form and return to the Student Activities office (Room #1102). “It is time for a new generation of leadership to cope with the new challenges and opportunities of our world. For those to whom much is given, much is also required.” Submit application to Mr. Goergen (Room #1102) NO LATER THAN Wednesday, September 7th, 2011.
  • 3. Application for enrollment Student Leadership Academy NAME: _______________________________________________ ID: _______________________ ORGANIZATION/CLUB: _______________________________ LUNCH PERIOD: __________ EMAIL: ______________________________________________ ARE YOU REQUIRED TO TAKE SLA? YES NO 1. Define Leadership 2. I consider myself a leader at __________________ because 3. I don’t consider myself a leader at _________________ because 4. When you think of yourself as a leader, what expectations do you have of yourself?
  • 4. 5. What expectations do you feel others have of you as a leader? 6. Leaders create positive change. What have you done to make a positive change in your world? Or, What would you like to do? 7. What most interests you about Student Leadership Academy? What do you hope to gain from the experience? 8. In what way do you plan to use the learning and experiences you receive from taking this course? Please return completed form to Mr. Goergen in the Student Activities office (Room 1102) no later than Wednesday, September 7th, 2011.
  • 5. Faculty/Staff Recommendation for enrollment in the Student Leadership Academy To the applicant: Please complete the first part of this form and give it to a faculty/staff member who has taught you, been your sponsor or coach. Name: _______________________________________ ID: __________________ To the recommender: The applicant named above is applying for enrollment in Stevenson’s Student Leadership Academy. Space is limited to 10 students per lunch period so close attention is paid to the faculty/staff recommendation. Your candid evaluation of this applicant’s leadership abilities and potential for success is greatly appreciated. Please include any information about the applicant’s social or academic background or emotional makeup that should be considered, including character factors. Your input is greatly appreciated. Please use the table below to compare the applicant with other students in his/her class, activity or sport No basis for Below Very Unusually Truly Average Outstanding judgement Average Good Good Exceptional Academic performance Independent thinking Quality of participation Writing ability Motivation Judgement and maturity Leadership ability Cooperation with others Recommendation (use reverse side if necessary): How long, in what connection, and how well have you known the applicant? __________________________________________________________________________________________ __________________________________________________________________________________________ Name: _______________________________ Date: __________ Please return recommendation to Ted Goergen in Student Activities by Wednesday, September 7, 2011.