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IU in DC | Honors Information Sheet

SPEA Honors Student Information Sheet

SPEA honors students who will be juniors or seniors and were admitted to the SPEA Honors Program are offered provisional admission pending interview. Students should also complete this form by Friday,  February 1, 2013 at 5PM and will then be contacted by the program director to schedule a short interview.

I. Contact Information
Last Name*     First Name*
Student ID*   IU Email*
Phone*      
Campus Address
Street*
City*   State*
Zip*      
Home Address
Street*
City*   State*
Zip*      
         
Have you ever had a criminal conviction, including a misdemeanor or felony, or had a civil judgment rendered against you?*
Yes If you answered yes, please explain  
No  
         
II. Academic Information
Current Status*   Expected Grad. Date*
Degree Pursued*   Major*
School*   Campus*
Cumulative GPA*  
         
List two SPEA Honors courses that you have completed or will complete before you start your WLP semester*
         
III. Essay
Why do you want to participate in the Washington Leadership Program? (250 word minimum)
         
V. References *
Please provide the names and contact information for two references. References should be from current or former professors, work supervisors, advisors or others who may be in a position to support your application.
Reference 1
Name
Relationship
Phone   Email
         
Reference 2
Name
Relationship
Phone   Email
 
V. Resume *
Please submit a copy of your resume  
         
VI. Pledge    
I hereby certify that I have completed this request to the best of my ability and in truth.*
 
* Indicates a required field.