Technovation For Good Program Leader Application

First Name *

Last Name *

Are you 18 or older *

Yes

Birthday *

Please enter your birthday, DD/MM/YYYY

Banner ID (if APP Student)

Email Address *

Permanent Address *

City *

State *

Zip Code *

Cell Phone Number *

What is/are your major(s)/minor(s) *

Anticipated graduation date *

How did you select your major/minor? *

Currently, what are your plans or goals after graduation? *

Give a specific example of a time when you went above and beyond the call of duty. *

Describe a time you had to deal with a difficult classmate/customer/co-worker. How did you resolve the situation? *

Please rate the following areas:

(1=Strongly Disagree, 2=Disagree, 3=Neutral, 4=Agree, 5=Strongly Agree)

I am a morning person. *

I am an effective communicator. *

I am professional. *

I prefer to be busy, rather than having a lot of down time. *

Punctuality is important to me. *

When circumstances or people are causing tension or discomfort in a group, I want to address them. *

Recommender 1 Full Name: *

Recommender 1 Email: *

Recommender 2 Full Name: *

Recommender 2 Email: *

Signature *

Date *

Month

Day

Year

Leave this field blank

Innovate for Good