STUDENT AMBASSADOR APPLICATION
MCC-Maple Woods
Step #1: Personal Information:
Name: _________________________________________________________
Preferred Phone: ______________________
Address: ________________________________________________________
Birthday: _______ /________ /___________
City: _______________________ State: _____________ Zip: ______________ MCC Student ID: _______________________
Are you a U.S. Citizen? ______ Yes _______ No If not, what is your country of citizenship? ____________________________
In what semester do you plan to join Ambassadors (Circle One):
Fall
Spring
School Year: ___________________
What is the number of credit hours you are enrolled in for the semester which you plan to join? _______________ Credit Hours.
Student Ambassadors are required to have at least a 2.5 GPA each semester to be an active member; What is your current
or most recent GPA? ___________________ on a 4.0 scale.
Shirt Size (circle one): XS
S
M
L
XL 2XL
In the space below, please list any scholarships, grants or financial aid you are receiving as a student here at Maple Woods:
Step #2: Reference Cards:
Please list below two references that are not related to you, but are familiar with your work style, personality and
habits. Please be sure to list accurate information on this portion of the application:
Reference #1:
Reference #2:
Relationship to you:___________________________
Relationship to you:___________________________
Name: _______________________________________
Name: _______________________________________
Address: _____________________________________
Address: _____________________________________
City: ____________________________________
City: ___________________________________
State: ______________ Zip: ________________
State: ______________ Zip: _______________
Phone #: ________________________________
Phone #: ______________________________
Step #3: Application Questions:
In this portion of the application, please answer the following questions, if you
need more room, feel free to attach additional paper.
Question #1: List the co-curricular activities, organizations, memberships, and clubs in which you have been
Involved in or are currently participating in.
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
Question #2: Describe the goals you have set for yourself in the following areas:
-Academics: __________________________________________________________________________________
______________________________________________________________________________________________
-Personal Growth/Development: _______________________________________________________________
______________________________________________________________________________________________
-Other Goals: _________________________________________________________________________________
_______________________________________________________________________________________________
Question #3: What is your definition of a good leader? ____________________________________________________
________________________________________________________________________________________________________
Question #4: What contributions could you make to the MCC-Maple Woods Ambassadors and the
Campus?
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
Question #5: What message would you bring to prospective students who are interesting in visiting campus?
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
Step #4: Finishing Up!:
_____________________________________________________
Signature
______________________
Date
Step #5: Delivery:
Please send completed applications to Marie Ridge in the Administration Building
Room 101. If you have questions, email her at jane.ridge@mcckc.edu or call her
at (816) 604-3028.