Application: Undergraduate Excellence Award 2009
International Student Services
Applications are due to the ISS office in room 217 of the Red Gym no later than Friday, March 20th at 4:00pm. You must hold junior or senior standing during the spring 2009 semester in order to be considered for the Meyerhoff Undergraduate Excellence Award.
Last Name: ______First Name: ______Middle Initial___
Campus Address: ______
Permanent Address: ______
UW ID# ______
Phone #: ______
E-mail:______
Major(s): ______Classification: Junior Senior
Grade Point Average: ______First semester at the UW: ______
Male: ______Female: ______
Please answer the following. Use additional paper if you need more space for any question.
Please share information about yourself, e.g. where you are from, what you are studying, if you work in addition to attending school and your career goals.
Please list the activities you have been involved in of a leadership or service nature on-campus since coming to UW-Madison. Include dates. Tell us the role(s) you played in each activity and describe what benefits have come to others as a result of your activities.
Please list the activities you have been involved in of a leadership or service nature off-campus/in the community since coming to UW-Madison. Please include dates. Tell us the role(s) you played in each activity and describe what benefits have come to others as a result of your activities.
Describe what it has meant to you to be involved in the above activities and to be a leader? (What have you gained?)
Have you ever won any other award for your academic scholarship? If so, please name the awards and when you won them.
Please provide any other information you would like the award committee to know that may help us assess your qualifications.
Please list two or three references who are aware of your leadership/service contributions:
1. ______
Name Relationship Phone number/e-mail
2. ______
Name Relationship Phone number/e-mail
3. ______
Name Relationship Phone number/e-mail