EmailMe Form - RegisCorps Membership Application

RegisCorps Membership Application

We are thrilled that you decided to apply to be a participant in RegisCorps. We believe that all students are capable of finding how to use their gifts and talents to become passionate leaders within and outside of the Regis Campus community. The Leadership Certificate Program challenges students to become leaders through classroom and experiential learning opportunities.

Enrollment Application Check-list

 Be in academically good standing: not on academic probation (please provide unofficial transcipt)
 Resume that includes leadership experience
 1 letter of recommendation can be submitted via email to ahieber@regis.edu or directly attached to this application
 Attached Letter of intent
 Completion of one para-curricular leadership course
 Completed this online application form

**Application is due on the Add/Drop Date of the semester that you are seeking to be accepted into RegisCorps. For example: a student takes the class in the Fall, the application would be due for the Add/Drop date of the following spring semester.

Name *
First Last
Email *
Cell Phone *
### - ### - ####
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Anticipated Year of Graduation *
Declared/Anticipated Major *
Declared/Anticipated Minor
Academic Advisor *
Cumulative GPA *
Please list current or recently-completed leadership positions at Regis or within other organizations *
Which para-curricular course did you complete making you eligible for RegisCorps application? *
PC 204E: Leadership Development Program Social Change
PC 204F: Leadership Development Program Heroic Leadership
PC 204G: Leadership Development Program Organizational Leadership
Other: Must be approved
If you selected "other" please describe which course you completed below.
What term did you complete your course? (Example: Fall 2017) *
Unofficial Transcript (Can screenshot or print and upload from Webadvisor) *
Letter of Intent

Please include a one to two page letter describing why you are interested in RegisCorps and what you hope to get out of it. Please reflect on your experience in the leadership course and address the following prompt:

St. Ignatius of Loyola, the founder of the Jesuits, wrote: “...Teach me to serve you as you deserve; to give, and not to count the cost...” How is this consistent with your leadership philosophy or does it challenge your current understanding of leadership? *
Resume

Includes current and prior leadership experience, employment, service and volunteer involvement, and other activities in which you are involved *
Letter of Recommendation

Faculty/Staff Member/Former or Current Supervisor, etc. Can be emailed to ahieber@regis.edu if requested. *
Would you like to be considered for the Elaine Perry Scholarship?
If accepted to the program, I understand that I am making an investment in the Regis University community and as such I commit my talents, abilities and intellect in the pursuit of the skills, experiences and personal growth to go out and serve the world as an agent of change. By signing this statement I agree to fully take advantage of the experiences that the RegisCorps Leadership Certificate Program provides. I understand that I represent both Regis University and RegisCorps during all retreats, conferences, service trips, field experiences or internships that I take part in. I agree to represent Regis University and RegisCorps as an engaged, respectful and professional member of this community. *
Clear
Please sign your name above.