ASRT Student Leadership Development Program Application

NORTH DAKOTA SOCIETY OF RADIOLOGIC TECHNOLOGISTS

ASRT Student Leadership Development Program Application

The ASRT Student Leadership Development Program offers multiple students a chance to get to know the ASRT, attend educational sessions and network with medical imaging and radiation therapy professionals. Funding is provided by the ASRT Board of Directors

NDSRT is one of the ASRT affiliates that opted to identify and select student participants who we feel have expressed interest in learning more about our state affiliate and would best benefit from this opportunity. Therefore interested candidates are to complete the SLDP application and submit to the designated NDSRT member administering the selection. Two students will be selected each year and their informationwill then be forwarded to the ASRT Practice Standards and Chapter Manager who will register the selected students as attendees of the ASRT Educational Symposium and Annual Governance and House of Delegates Meeting which is typically held Thursday through Sunday, mid to late June.

Selected participants receive:

Airfare, housing, stipend for meals and other travel expenses

An educational program designed just for students

A professional mentor assigned for the meeting

An insider's look into the largest association for medical imaging and radiation therapy professionals

Eligible candidates must:

Be enrolled in an accredited medical imaging or radiation therapy program at the time of submission

Be a student member of NDSRT and ASRT at time of submission and participation

Be able to participate in all required orientations and mandatory events of the SLDP

Application acceptance begins September 5 and ends December 5 the year preceding annual conference. It is the sole discretion of NDSRT to accept or reject any submission. All NDSRT decisions as to the administration, methodology and selection of students are final.

If you are selected by NDSRT as an affiliate student participant, ASRT will require you to1) complete the ASRT online application 2) provide a recommendation/permission letter stating that you have your program director’s approval to attend the annual meeting in June. To consider your application complete, the ASRT application and copy of the letter must be sent to the ASRT at by the ASRT established deadline.

Student Leadership Development Program Application

1. Personal Information

Mr. or Ms.(circle one)

Name:

Mailing Address:

City, State ZIP:

Home phone:

Cell Phone:

Email address:

ASRT member #:

2. Educational Information

Name of Radiologic Science Program:

Address:

City and State:

Program Director Name:

Phone:

Email Address:

Program Type: (circle one)Certificate / Associate degree / Bachelor’s degree

Anticipated Graduation Date:

3. Essay Submission: Type a 500-700 word essay answering the following questions:

a.How would you grow professionally from your participation in the Student Leadership

Development Program?

b.Have you attended any events or activities of NDSRT in the past? If so, please give

a description as to the date, location, specific details of the event and your level of participation.

c.What are your short term (2 year) and long term (3-5 year) career goals?

d.Do you have an interest in being a future candidate for elected positions on the NDSRT

Board?