Name:

Last First XID Number

Mailing Address:
Street Apt #/P.O .Box


City State Zip

Telephone: Email:
Cell Home or Other

Primary Campus You Attend: Date of application:
mm/dd/yy

Year at LSSC: Incoming Freshman Freshman Sophomore Junior Senior


Are you dual enrolled? Yes No (Please note dual enrolled students are not eligible for the scholarship.)


Position you are applying for: President Vice President Secretary Treasurer Senator

Director of Service Director of Activities Director of Education
Director of Fundraising Director of Public Relations

Recommendation: Provide two letters of recommendation (email is acceptable)

Answer the following questions on a separate piece of paper (typed) and submit with your application:
1. What is your understanding of LSSC SGA and their role on campus?
2. List reasons why you would like to be an officer of SGA.
3. Describe your previous leadership experiences.
4. List your ideas for programs and/or activities that might increase student participation.
5. List your other commitments for the year (number of classes, work, other organizations, etc.)


If selected, I understand and accept the following requirements.
1. I must currently have and maintain a cumulative GPA of 2.5
2. I must be enrolled in a minimum of 6 hours per semester to receive a service scholarship.
3. I will make a one-year commitment including consecutive fall and spring semesters.
4. I will be available for an interactive & formal interview in the summer. The dates will be announced.
5. I understand the service scholarship will be awarded at the end of each semester based on fulfillment of my duties.
5. I will serve a minimum of 4 office hours per week and attend weekly SGA and monthly college-wide meetings.
6. I will participate in community service hours during the year.


Please return completed application to the Student Life Office on your campus:


Leesburg South Lake
Cindy Lackey Linda Karp
352-363-3650 352-536-2147
LackeyC@lssc.edu KarpL@lssc.edu

SD: Revised 5/5/14
STUDENT LEADER APPLICATION

Student Government Association

South Lake