Raven Ambassador Application

Date *

Month Day Year

Hour Minutes AM/PM Option

Name *

First Name Last Name

Address *

Street Address

Street Address Line 2

City State

Zip Code

RACC Email Address

example@ravens.racc.edu

Phone Number *

(123) 123-1234

Student ID# *

full student id # (numbers only)

GPA: *

GPA Institution: *

Select your academic program: *

List clubs and activities in which you are involved: *

Please list or explain any other campus responsibilitiesthat your have assumed as a student: *

Write a brief essay and upload the file with your submission.

Instructions: In your essay, discuss why you would be a good choice for the Raven Ambassador program, what you hope to gain from it, and what you feel you can contribute to this program. Your essay should be typed in Word, and no more than 250 words in length.

File Upload

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Individual interviews: TBA

Please provide a list of 3 references.

Reference 1: Name *

Reference 1: Phone Number *

Reference 1: Relation *

Reference 2: Name *

Reference 2: Phone Number *

Reference 2: Relation *

Reference 3: Name *

Reference 3: Phone Number *

Reference 3: Relation *

Let us know you are a human *

RACC Raven Ambassador Application

Please provide a list of 3 references.