The Kerry Capstick-Dale

Student Leadership Awards

These two awards are designed to recognise and perpetuate excellence and achievement in student leadership. This gives the awards a unique niche and positioning at the university, because they are neither bursaries nor merit awards for academic success.

These awards are deliberately focused on rewarding and encouraging student leaders who – by virtue of the time they commit to the university community outside the lecture theatre – enrich the life of UCT. They seek to reward students who, through exceptional leadership qualities in student affairs, have shown dedication to the University of Cape Town and have advanced the ideals of the university’s Mission Statement. Such students must display an enlightened approach to life, generosity of spirit, humour and integrity.

To our knowledge, outside of UCT and the vice-chancellor’s awards, these awards are unique in all of Southern Africa, and there appears to be no comparable award at any other university in the sub-continent. It does have certain conceptual parallels with the illustrious Rhodes Scholarship.

Awards are made annually and application forms must be submitted by 13 June this year. Shortlisted students should make themselves available for a personal interview by the Selection Panel on 06 August, and the Awards will be made at the same time as UCT’s Student Leadership Awards on 06 October.

These awards are generously funded by Pick n Pay.

PLEASE COMPLETE IN BLOCK LETTERS

NB: PLEASE ANSWER ALL QUESTIONS

A. / PERSONAL PARTICULARS
1. / surname / title
2. / first names
3. / date of birth
4. / permanent address
postal code / tel. no.
cell no.
email address
5. / place of residence while attending university: (please tick )
parent’s home / private lodgings/digs / other
own home / university residence
other student’s residence/hotel
6. / home language / english / other
7. / previous awards:
please give details of all previous bursaries, scholarships or awards, if any (while at university):
year / name of award
B. / UNIVERSITY DETAILS
* please note that only students registered for the academic year are eligible to apply.
1. / current degree at uct
2. / faculty
3. / standard number of years to complete degree
4. / number of years at uct (incl. this one)
5. / student registration number
6. / whilst this scholarship is not an academic award, the selection committee is interested in your academic pursuits and performance. please list below or attach recent transcript

subject and result

/ subject and result
C. / ACHIEVEMENTS
describe your achievements, participation (not just membership) in organisations, and leadership roles while at university. – please give all relevant dates
D / OTHER INTERESTS AND ACTIVITIES
1. / please provide a short personal statement describing how your attributes might best be applied to the ideals of these awards:
2. / what are your leisure interests, sports and hobbies:
3. / what sort of career or work do you anticipate following after completion of your degree? please explain your reason for this choice:
4. / please provide any other information you think may affect this application:
5. / please state what has motivated you to be involved in student affairs / organisation:
E. / TESTIMONIALS
note: attach one testimonial in support of your application.
1. / name of person from whom testimonial is attached and relationship to applicant (e.g.: lecturer).
name / relationship
2. / candidates may attach a curriculum vitae to this application form.
please note the following:
·  this application form must reach the committee by 13 June 2009.
·  candidates will be assessed according to the ideals of the award outlined on the front page of this form; the decision by the adjudication panel is final.
i have read and understand the notes above. i hereby confirm that the information provided in my application is accurate and true.
date / signature of applicant

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