2014-2015 Leadership Award This award is to recognize a student that has shown excellent leadership as a student at West Georgia Technical College. Application is due JULY 18th - Student can self-nominate or be nominated by a faculty or staff member. Student must have a minimum 3.0 GPA and an average Work Ethic grade of 2 Student must be enrolled full time in order to receive award Must have West Georgia Technical College Employee Signature on application 200 Words or less students will “Describe how you have shown leadership at WGTC” Name ________________________________________________________________________________ Student ID ________________________________ Phone ___________________________________ Email __________________________________________________________________________ Mailing Address __________________________________________________________________ City _____________________________________ State ______________ Zip_______________ Do you give the Office of Student Activities permission to review your grades: □ Yes □No Please indicate the terms that you plan to enroll full time: □ Fall 2014 □ Spring 2015 □ Summer 2015 Approving West Georgia Technical College Employee Signature_________________ **Please submit a brief essay (200 words or less) answering the question below to studentlife@westgatech.edu with your name and student ID number** “Describe how you have shown leadership at WGTC” For office use only: Does student meet grade requirements? Is student full time? Essay received: Scholarship Awarded Yes Yes Date: Yes No No No