Campus Leadership Programme Application

Campus Leadership Programme Application
Email address
example@example.com
Personal Information
Name

First NameLast Name
Preferred Name
Pronouns
Religion (including denomination where applicable)
Date of Birth

DayMonthYear
Date
Do you have any dietary requirements? If so please list
Do you have any access needs?
University Information
University
Year of Study
Are of Study/Subject
Contact Information
Contact email address (please share a personal non-university email address)
example@example.com
Phone Number
Contact Address (term time)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact Address (Home)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
At CCJ we take your privacy seriously. You can access our full privacy policy by visiting our website or by contacting the office. Please note, data protection legislation requires us to have your express permission to contact you regarding CCJ activities. Please indicate using the boxes below how you would like us to contact you.
Interfaith on Campus
How are you currently involved in your university and faith community? (maximum 500 words)
max 500 words
Why do you think interfaith at university is important? (maximum 500 words)
max 500 words
What do you hope to gain from being a CCJ Student Leader? (Please include skills, information, experience you hope to acquire. maximum 500 words)
max 500 words
What do you perceive as possible challenges between people of different faiths and faith communities on campus? (maximum 500 words)
max 500 words
Have you seen or heard of any positive interfaith initiatives locally? If yes please expand... (maximum 500 words)
max 500 words
Campus leader nominations (optional)

Is there someone you'd like to be a co-campus leader with on your campus, ideally of a different faith, or is there someone on another campus you think would make a great campus leader? If yes fill out the nomination section of the application form. Please note this is completely optional and not a requirement for applying to the programme.
Is there someone you would like to work with on your campus?
If there is someone you would like to nominate either on your campus to work with or on a different campus who you think would be good for the programme please make sure you ask permission to share their contact detials so we can be in touch and share the application.
Name

First NameLast Name
Email
example@example.com
University campus
How did you hear about CCJ's Campus Leadership Programme?

Other
Permissions
I give permission for photos of me at CCJ events to be used by CCJ for publicity
Would you be happy to be put in touch with some of our contacts which may include, programme alumni, local chaplaincy, other groups societies, and or the student union?
If you are successful in your applciation to be a Student Leader you agree to:

- Hold two events at your university (one in Interfaith Week and one in the second semester)

- Write/create an article, blog, reflection for CCJ

- Meet with your mentor at least once a semester

- Attend a training residential this years dates are 7th-9th September (we understand in some circumstances this may not be possible and will try accomodate as best as we can)
Signed
Date

DayMonthYear
Date
Should be Empty:

Campus Leadership Programme Application

Personal Information

University Information

Contact Information

Interfaith on Campus

Campus leader nominations (optional)

Permissions