CCC Step into Leadership Student Submission Form

Corpus Christi College "Step into Leadership" Nominated Excellence Award Application Form (to be submitted by student)

This form can only be saved at submission. Please allow yourself to have at least 30 minutes to complete the application form, and have your essay prepared and ready to upload.
Full Name *

First Name Middle Name Last Name
Gender *

Male Female
Birth Date *

Day Month Year
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number *

Area Code Phone Number
E-mail *
High School
Expected date of graduation *

Day Month Year
Name of high school *
School address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
School phone

Area Code Phone Number
Are you currently completing the final year of high school in your province or territory? *

Yes No
Previous High School
Grades Attended
Career/Occupational Interests

List up to three careers or occupations you are considering. If you don't know yet, indicate "uncertain".
Career/occupation #1 *
Career/occupation #2
Career/occupation #3
Educational Intentions after High School
Anticipated course of study and degree/diploma sought. *
Anticipated start date

Month Day Year
Outstanding Community Leadership
Complete and submit an answer to the question: What does inspirational leadership mean to you? (not exceeding 400 words) *
Summarize your most important community activity or achievement (max. 200 words) *
Leadership References

Provide names and contact information for one community referee and one high school referee who can comment on your leadership and community involvement in a confidential reference letter. Letters can be submitted by email to enrolmentservices@corpuschristi.ca or mailed to Corpus Christi College. **Please note: Reference letters previously submitted as part of the CCC admissions application will not be accepted.**
1. Community Referee *

Prefix First Name Last Name
Position / organization *
E-mail *
Phone Number *

Area Code Phone Number
2. High School Referee *

Prefix First Name Last Name
Position / organization *
E-mail *
Phone Number *

Area Code Phone Number
Extracurricular Activities

List extracurricular activities in which you have participated, if any, and specify the nature of your involvement in each.
Activity #1
Activity #2
Activity #3
Work Experience

List summer or part-time jobs you have held, if any, specifying employer, type of work and length of time in position.
Employer #1
Employer #2
Employer #3
Student Declaration
I hereby declare that the information on this application is, to the best of my knowledge, correct and complete. I understand that Corpus Christi College retains the right to verify information on my application. If I am the recipient of an award, I understand that by signing this declaration, I permit Corpus Christi College to: release to an award donor, university faculty and administrative staff my name, address, telephone number, year and program of study; release to Award Adjudication Committee members the information provided in this application form; prepare a brief biographical profile to be used for award presentation ceremonies, publications and the Internet; and prepare lists of award winners to be published or included in graduation ceremonies.
Signature *
Should be Empty:

Corpus Christi College "Step into Leadership" Nominated Excellence Award Application Form (to be submitted by student)

High School

Career/Occupational Interests

Educational Intentions after High School

Outstanding Community Leadership

Leadership References

Extracurricular Activities

Work Experience

Student Declaration