SIR – STUDENT INVOLVEMENT RECOGNITION Student Application Form (copy 1)

To be filled out by the applicant

1. Full name*

2. Category of Involvement you are interested in*

Cultural and Artistic - Activities that involve creating, producing, organizing or exhibiting work that enriches cultural life

Sustainable Development - Activities aimed at raising awareness of environmental, social and economic issues related to sustainable development, including sharing knowledge and promoting responsible action and involvement for the benefit of current and future generations. This area recognizes skills such as leadership, organization, teamwork and interpersonal communication.

Entrepreneurial - Activities that put the student at the heart of a business project

Political - Activities aimed at defending the rights and interests of students or other social groups, and participating in provincial, national and international social debates

Scientific - Scientific or technical activities that involve research, testing or popularization

Scholastic - Activities that are an extension of the student's program of study and career path

Social and Community - Activities that improve the quality of life of members of a community and contribute to promoting greater civic engagement

Sports - Activities involving not only student athletes, but also student coaches and student members of sports committees

3. Where will you be completing your involvement?*

A. Heritage or Heritage linked organization. (Fill in Question 4-7)

B. Community organization not connected to Heritage. (Fill in Question 8-12)

4. (If you choose A in the Question 3) Briefly describe what you will be doing to obtain your 60 hours of student involvement.

5. (If you choose A in the Question 3) List your personal objectives for your student involvement hours.

Please don't respond to the following questions they will be completed following a meeting with the SIR coordinator.

6. (If you choose A in the Question 3) Did the student meet with the SIR coordinator before starting?

7. (If you choose A in the Question 3) Additional required documentation.

8. (If you choose B in the Question 3) Provide details of host organization.

9. (If you choose B in the Question 3) Briefly describe what you will be doing to obtain your 60 hours of student involvement.

10. (If you choose B in the Question 3) List your personal objectives for your student involvement hours.

Please don't respond to the following questions they will be completed following a meeting with the SIR coordinator.

11. (If you choose B in the Question 3) Did the student meet with the SIR coordinator before starting?

12. (If you choose B in the Question 3) Additional required documentation.

SIR – STUDENT INVOLVEMENT RECOGNITION Student Application Form (copy 1)

Criteria for Recognition of Involvement

SIR – STUDENT INVOLVEMENT RECOGNITION Student Application Form

Main Campus

Pontiac Campus

Criteria for Recognition of Involvement

SIR – STUDENT INVOLVEMENT RECOGNITION Student Application Form

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Main Campus

Pontiac Campus