Name:
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
VGCC Email:
example@vgcc.edu
Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
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Mississippi
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New Hampshire
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New York
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Ohio
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Virginia
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West Virginia
Wisconsin
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State
Zip Code
Candidate's Information
Major/Program of Study:
*
Student ID:
*
Expected Graduation Date:
*
Indicate language spoken, other than English.
*
Summarize your reason for applying. What attracts you to this type of position?
*
What are your extracurricular activities? Other leadership roles you have on/off campus? Please list all Student Organizations you have served in at VGCC.
*
How would most of your instructors describe you?
*
STATEMENT OF COMMITMENT:I have reviewed the ambassador application information and agree to support the guidelines of this program. I am aware that if selected, I will be involved in ambassador activities for approximately 10 hours per month, will be required to take the Leadership Development course/training, and maintain a 3.0 GPA.Should ambassador scholarship recipients, at any time, drop out of school or fail to successfully perform their responsibilities, the remainder of funds for the academic year shall be retained by the Vance-Granville Community College.
*
Agree
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Signature
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