Lead4Success Student Facilitator Application

Please fill out the following information:

Name Name First Last
CWID
Email
Phone Phone - ### - ### ####
Academic College
What is your class standing?

What is your class standing? Freshman Sophomore Junior Senior Graduate Student
What is your gender identity?
What race/ethnicity do you identify with? (Check all that apply)

What race/ethnicity do you identify with? (Check all that apply) White or Caucasian Black or African American Hispanic or Latino American Indian/Alaskan Native Asian or Asian American Native Hawaiian or Pacific Islander Other not listed above: Other not listed above:
Please share why you are interested in the Lead4Success Student Facilitator position.
As outlined in the position description, this role requires autonomy and initiative. Please expand on a time when you were a self-starter and how you practiced time management.
This role is primarily facilitating curriculum to groups of students. Please share your experience facilitating curriculum and/or or presenting to a group.
From the choices below, please indicate which dates you are available to interview. Keep in mind interviews will be no longer than 30 minutes. Interview times are TBD.

From the choices below, please indicate which dates you are available to interview. Keep in mind interviews will be no longer than 30 minutes. Interview times are TBD. Monday, April 24th Tuesday, April 25th Wednesday, April 26th Thursday, April 27th Friday, April 28th
If selected for the position, you will be required partake in the certification process to become an official, certified L4S Facilitator. Please indicate below which dates and times are most conducive to your schedule for the facilitator training.

Please note: Times may change if needed, but this is to give us an idea of your availability.

If selected for the position, you will be required partake in the certification process to become an official, certified L4S Facilitator. Please indicate below which dates and times are most conducive to your schedule for the facilitator training.

Please note: Times may change if needed, but this is to give us an idea of your availability. Wednesday, August 16th Thursday, August 17th
Please indicate if you have any dietary restrictions we should know about below.