Application Form for Student Advisory Board Member

APPLICATION FORM FOR STUDENT ADVISORY BOARD MEMBER

Personal Information:

Date:

Name:

Address:

Phone Number:

Email Address:

Educational Background

If you are a Masters Student, what is your specialization?

If you are a PhD Student, what is your area of research?

Please list all of the colleges or universities you have attended

Institution Dates Attended Degrees/Field

1.

2.

3.

Professional Background

Please list your three most recent work experiences

Organization Title Start/End Date

1.

2.

3.

Attach Resume and Essays

In an additional Word document, please include your resume, and answer the following questions in essay format:

1. What do you, as a student of the Bren School of Environmental Science & Management, believe you would be able to contribute to the Advisory Board if you were appointed a Student Member?

2. As a Student Board Member, how would you be an effective representative of the Bren School student body, and how would you communicate relevant information to the students, as well as your fellow Board Members?

3. Describe your short-term (3-5 years) and long-term (10-20 years) goals in the field of Environmental Science & Management?

Essays should be single spaced, and no longer than one page in length. Please include your name and question number on each page. Begin each essay on a separate page.

Please email all of your information to Doris Bleecher, Assistant to the Dean at no later than Monday, November 1, 2010 by 4:00 p.m.