application - Central Piedmont Community College

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2014-15 Ruth G. Shaw Women’s Leadership Program
at Central Piedmont Community College
Please read this application thoroughly and complete all sections.
Dr. Ruth Shaw, CPCC’s second college president, oversaw the development of comprehensive campuses throughout
Mecklenburg County to accommodate the increasing needs of the growing community. As a result, CPCC is now the largest
community college in the Carolinas, serving more than 70,000 people at its six full-service campuses.
Following Dr. Shaw’s presidency at CPCC, she served as president and chief executive officer of Duke Power Company, now
Duke Energy. She served on the board and led community campaigns for both United Way of Central Carolinas, Inc., and the
Arts and Science Council. Dr. Shaw holds a Bachelor of Arts (magna cum laude) and a Master of Arts degree in English from
East Carolina University, and a Ph.D. in higher educational administration from the University of Texas at Austin.
Dr. Shaw remains a loyal supporter of the College, and as a result of her generosity CPCC Foundation has created the Ruth G.
Shaw Women’s Leadership Program at CPCC. In addition to providing techniques students can use to navigate college and
life’s opportunities and challenges, the program aims to:
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Connect women to one another and to a supportive network of faculty, staff and community mentors.
Inspire women to assume positions of leadership and to celebrate their individual and collective achievements.
Nurture female leaders by encouraging and demonstrating critical thinking, intellectual curiosity, and problem-solving
strategies.
Foster a deeper awareness of the many roles women play and their contributions to society.
The Program, limited to 10 female students who have completed or who will complete in fall 2014 CPCC’s Emerging Leaders
Program, includes an application process and annual commitment but offers exclusive benefits including scholarships.
In addition, through monthly luncheons and guided conversations with community mentors, the Ruth G. Shaw Women’s
Leadership Program offers interaction with College leaders, faculty, staff and alumnae; personal and professional skill
development; hands-on leadership development; and recognition of achievement. As a culminating event and in collaboration
with faculty, staff and mentors, participants will plan and execute an annual spring symposium for the community.
Meeting Schedule
August 22 – Orientation Session
September 5, 12-2pm
October 3, 12-1:15pm
November 7, 12-1:15pm
January 9*, 12-1:15pm
February 6, 12-1:15pm
March 6, 12-1:15pm
April – Symposium date TBD
*There will be no December meeting and January’s meeting will take place on the second Friday. Meetings will be held on Central Campus.
A staff committee will select participants based on the following criteria:
 Responses provided in this application
 Presentation and responses provided during face-to-face interview
 Involvement in student and/or community organizations
 Demonstrated leadership potential
 Academic motivation and progress
 Broad representation of student population
 Participation in CPCC’s Emerging Leaders Program
Please submit your application to any CPCC Student Life Office by 5pm, Wednesday, April 16.
Date received: ____________________________________
Staff Initials: ___________________________________
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2014-15 Ruth G. Shaw Women’s Leadership Program
at Central Piedmont Community College
First Name
MI
Home Phone
Cell Phone
Street Address
Last Name
Student ID#
Preferred Email
City/State
Zip Code
 I have completed CPCC’s Emerging Leaders Program.
 I am a current participant in CPCC’s Emerging Leaders Program.
 I am at least 18-years-old (participants must be 18 to participate).
Curriculum Program
Credit Hours Complete
GPA
CPCC Campus where you primarily attend classes:
 Cato
 Harper
 Central
 Harris
 Levine
 Merancas
Interview Availability – please indicate days/times that you are available for an interview the week of April 21, 2014.
Monday, April 21
Tuesday, April 22
Wednesday, April 23
Thursday, April 24
Friday, April 25
7:30-9am
9am-12pm
1-5pm
5-6:30pm
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Please list any CPCC organizations with which you are involved currently:
Please list any community involvement or volunteer work in which you participate regularly:
Please list any leadership positions that you hold or have held within the past 12 months:
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2014-15 Ruth G. Shaw Women’s Leadership Program
at Central Piedmont Community College
Please provide your type-written responses to the questions below and attach them as a separate document to this application.
Your responses are an important factor in the selection process. Please provide thoughtful consideration as you reply so that
the committee can best understand your desire and intent to participate in the Ruth G. Shaw Women’s Leadership Program.
1. Why do you want to be a part of the Ruth G. Shaw Women’s Leadership Program?
2. What is your personal definition of leadership?
3. Please provide an example of a female leader and her leadership that you have personally observed.
4. Please describe what you would like to learn about yourself during this program, and why that is important.
5. How do you intend to use what you learn in this program in the service of others?
Assumption of Risk
I, the undersigned, being over the age of 18 years, do hereby acknowledge that there are risks of physical harm and injury
inherent in off-campus activities including, but not limited to, working with people, participating in program-related activities
and field trips. As partial consideration of being allowed to participate in this CPCC program, I hereby assume all risks in the
travel and related activities and hereby knowingly and intentionally waive any and all claims, or whatsoever kind of nature,
against such institutions which may arise out of this activity. I specifically acknowledge that my participation in this program is
voluntary. I further state that I am not, in any capacity, an employee of CPCC. I specifically grant this waiver of claims for
myself and will indemnify and hold harmless such institutions and individuals from any claims.
CPCC promotes a drug-free environment. Absolutely no substances, including tobacco, are permitted during program-related
activities.
I acknowledge that I have fully read and understand the information presented to me in this application.
Applicant Signature
Date
Faculty/Staff/Advisor Recommendation
To the Student: Participation in this program requires recommendation of a CPCC instructor or your student organization
advisor. Please have this person recommend your participation with a signature below. If need be, the selection committee
may choose to initiate contact with this person for additional information.
To the Faculty/Staff /Advisory Member: This applicant/student is interested in participating in the Ruth G. Shaw
Women’s Leadership Program. In this program, the student is expected to work cooperatively with other students and
mentors for the purpose of developing her leadership potential. At the end of the project, students, mentors, faculty and staff
will work together to plan, promote and execute a community-wide event. Your signature acknowledges your endorsement of
this student’s ability to fully participate and contribute positively as expected. If you prefer, you may also email a statement of
support to student.life@cpcc.edu.
Faculty Signature
Printed Faculty Name
Department
Date
Email
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