Programs- 2009 - 2010 Presidential Citizen Scholar Program - Application
Presidential Citizen
Scholar Program
Application Form (2009 - 2010)
Please note:
This form is for students who have been invited to the Program.
Please print out the form and submit it to PACE.
Name __________________________________________
GPA ______________________
What year will be you be in 2009 - 2010________________________________________
(junior or senior)
Student ID#
________________________
Major (and Minor)
___________________________________________________________
Contact Information
Preferred e-mail address ________________________________________________
Telephone # (where you live)
______________________________________________
(cell phone #) _______________________________________________
Permanent Mailing Address
_______________________________________________
___________________________________________________________
Will you be studying abroad anytime during the 2009/2010 school year?
What is your expected date of graduation?
List your civic experiences (if any) and why you would like to become a Presidential Citizen Scholar (on a separate sheet of paper in 100-200 words).
___________________________________________________________________________
* This is a 1-year program that involves:
2 PACE academic seminars
3 civic lectures/events and reflections
Volunteer experiences totaling 4 hours w/reflection
Final 3-page reflection essay
Print this form and fax it to PACE at 410-677-5012 or mail it to the address below:
Institute for
Public Affairs and Civic Engagement (PACE)
Salisbury University, 1101
Camden Ave., Salisbury, MD 21801
410-677-5045
Comments and questions about this page can be directed to PACE
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