Bonner Leader Program Application
Name
*
First Name
Last Name
Student ID Number
*
Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Home Phone
*
Cell Phone
*
Middlesex College Email
*
example@example.com
Personal Email
*
example@example.com
Major
*
Number of Credits: Fall
*
Current Middlesex College GPA (High school for incoming students)
*
Expected Year of Middlesex College Graduation
*
Are you eligible for work study/financial aid?
*
Yes
No
Not Sure
* If you are not sure whether you are eligible, please contact the
Financial Aid office
.
Do you have available transportation?
*
Yes
No
Can you commit to completing at least 10 hours of service per week throughout the academic year (September – May)?
*
Yes
No
Please explain
*
Are you available Tuesdays from 2:00 p.m. – 3:30 p.m. to attend mandatory weekly Bonner Leader Program meetings? Please note, Tuesdays at 2 p.m. is College Hour during which classes are not typically scheduled.
*
Yes
No
Please explain
*
Do you have other employment or any other major commitments planned for the upcoming year?
*
Yes
No
Please explain
*
Short Essay Questions
Please respond as thoughtfully and as fully as you feel necessary to the following questions. They are designed to give you an opportunity to relate the experiences that qualify you to be a Bonner Program member. Responses should be typed and no more than 150 words each.
What issue/s in the world today are you most passionate about? Put another way, when you watch or read the news or simply live your life, what issue grabs your heart and head and won't let go? Why?
*
Please describe a past or current volunteer experience and what you learned through your participation. If you have not volunteered or performed service in the past, please explain service that you would like to do in future and what you hope to gain from it?
*
Please verify that you are human
*
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