College of DuPage Office of Student Life

Living Leadership Program Application

Applicants must meet the eligibility requirements.(See Learning Agreement)

General Information
Full Name:

C.O.D. Club Affiliation (if any):

E-mail:

Mailing Address:

Home Phone: Cell Phone:

Birth Date:
(for enrollment verification)

Application Questions:

How did you hear about the Living Leadership Program at College of DuPage?

What attracted you to participate in the program?

Were all of the requirements, objectives and criteria of the program clearly explained to you? YES NO

By signing and submitting this application, I will meet or exceed the expectations of the Living
Leadership Program. I understand that by signing this, I am making a commitment to participate.

Signature: _____________________________________________________ Date: ____________________________________

Applications accepted May 1st to September 2nd in the Office of Student Life
Student Resource Center 1800
After August 1st please return to Student Services Center 1217

If you have any questions, please contact:

Stephanie Quirk
quirks@cod.edu
 Living Leadership Program
Learning Agreement

In order to get the most out of the program, you need to make a commitment to what it entails. You will need to make the
choice to “step-up” to the opportunities presented to you. The Living Leadership Program will not allow behavior that is
contradictory to this commitment to impede or distract from the experience of other participants. Thank you for helping us to
insure an extraordinary year for everyone involved.

1. I understand that participating means listening, sharing my viewpoint, and participating in activities.
2. I agree to take responsibility for my own learning. I agree to ask questions if I don’t understand, participate even if I
have done an activity before, and challenge myself to step out of my “comfort zone” this year.
3. I agree to respect individual differences and the dignity of all people. I will keep an open mind and strive to learn a
new perspective on the world.
4. I agree to conduct myself to the highest standard of behavior in accordance with the Student Code of Conduct.
5. I agree to maintain effective communication with my fellow program members and College of DuPage staff.
6. I agree to fulfill the qualifications, objectives and requirements outlined below:
QUALIFICATIONS for Membership
 Be a currently enrolled student in at least one credit hour
 2.0 cumulative gpa or higher (waived for first semester students)
 In good standing with the college (no financial or academic holds on your record)

OBJECTIVES
Upon successful completion of the Living Leadership Program the student should be able to do the following:
1. Explain their personal leadership philosophy
2. List their strengths as a leader and the significance of each strength
3. Interpret the three tenets of leadership in the context of their student group experience
4. Demonstrate a commitment to service and intention to continue giving back to the community
5. Apply the Three Tenets of Leadership Model to identify leadership in others
6. Translate outside lessons into actionable strategies to practice leadership

REQUIREMENTS to complete and receive a Leadership Certificate:

Coursework – 3 hours
o Humanities 2210; Leadership Development
Experiential
o Active participation in a student club, organization or team on campus
Directed Development – Choose 2
o COD Student Leadership Retreat (Aug 1 & 2)
o ICCSAA Leadership Conference (Oct 21 & 22)
o Other conference (must have prior approval)
Case Studies – Choose 3
o Personal Leadership Mentor
o College Lecture Series Speaker (2 Each Year TBD)
o Other speaker on campus or off campus (must have prior approval)
Service – Choose 1
o Service Learning in class (including being a Student Ambassador)
o Extended service outside of class of 16 or more hours at a single approved location
Capstone Project
o Leadership portfolio (please see Leadership Portfolio Checklist)

We ask that you agree to the previous statements and demonstrate this commitment by signing this document below.

Living Leadership Participant Signature Date

Please print name

Thank you! It is inspiring to know you will be spending your time with us
working to better yourself and ultimately your community.