2015 – 2016
Prairie View High School
8th Grade Leadership
Application
Class of ’19
Instructions
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Complete all parts of this application and scan it. Then please email it to
kpurfurst@sd27.org.
This is due February 20th.
If you are selected as a potential candidate based on your application you will be
contacted to conduct an interview.
If you have any questions, contact Kevin Purfurst at 720-560-0118.
2015 - 2016 Prairie View High School Leadership Application
Leadership is a year-long course. Students participating in Leadership are Class Officers,
Committee Chairs, and Leadership Members elected and/or appointed following an
application and interview process. This course is designed to develop students’ skills in the
areas of goal setting, problem solving, creative thinking, communication, meeting skills,
organization, group dynamics, and social issues. Students will be required to participate in
Student Council activities in a planning and support role. They will also be required to
complete 20 hours of community service over the semester, in addition to their graduation
requirements. Students will be required to participate in a substantial amount of activities
outside of the scheduled academic day.
Eligibility Requirements
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Sign and abide by the Leadership Contract
Have and maintain at least a 2.0 GPA (cumulative)
Be eligible according to CHSAA standards
Have no significant disciplinary issues
Have a strong attendance record
Attend and actively participate in the significant number of StuCo events before and
after school, and on weekends
Leadership Contract 2015-2016
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I will remember at all times that I represent Prairie View High School students, faculty and staff, and that
my behavior will be such that it will bring respect to my class, the school, my family and myself.
I will always adhere to the Student Council mission statement: “The mission of Prairie View High School
Student Council is to be accountable for our role by creating a positive environment and promoting
inclusion, spirit, and diversity within our school and community.”
I will always to adhere to the Student Council pillar of accountability.
I will always to adhere to the Student Council pillar of inclusiveness.
I will always to adhere to the Student Council pillar of spirit.
I will attend 80% of all mandatory Student Council events.
I will clear all absences to mandatory Student Council events with the advisor or a designee.
I understand that all Student Council members are expected to adhere to the pillars of Student Council
and mission statement at all times, and that failure to do so at the discretion of the advisor will result in
removal from Student Council.
I understand that failure to adhere to this contract as determined by the advisor will result in my
removal from Student Council.
Contact Information
Please provide your current contact information so that you can be contacted about your
application.
Print Student Name: _________________________________________________________________________________
Year in School at this Time (Circle One): 8th
Home Address: ___________________________________________________ City, Zip _________________________
Cell Phone Number: _____________________________ Home Phone Number: _________________________
Email Address: __________________________________________________________________ Shirt Size: ________
Courses for Next Year
Please list the courses, other than Leadership, that you anticipate taking next year to help
us understand what your schedule might look like.
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Extra Curricular Activities
Please list the extra curricular activities (sports, clubs, work, etc.) that you are or will be
participating in next year.
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Leadership Positions
Please list the different leadership positions that you have previously held or currently
hold.
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Behavior
Leadership members must be in good standing for their behavior. By signing below you
attest that you have not received any significant disciplinary actions against you through
the school (including but not limited to: referrals, community service, suspensions, etc.) or
in the community (including but not limited to: tickets, etc.).
Student Signature: ___________________________________________________________________________________
Grades
Leadership members should have high grades to model for all PVHS students. A cumulative
G.P.A. of 2.0 is a minimum requirement. I understand that I must currently have at least a
2.0 G.P.A. (cumulative) with no failing grades in classes for the Fall Semester in order to be
eligible for this position.
Period
Current Grade
Course Name
Date
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Student Signature: ___________________________________________________________________________________
Short Response Questions for New Applicants
Please complete the following questions in about 150 words each.
1. What is leadership?
2. Student leaders show qualities that distinguish them from others. What makes you stand
out in a crowd? What distinguishes you from your peers?
3. Why is it important to serve others, and what have you done to serve others?
Student Level of Work and Commitment
I, _______________________________________, understand that as a member of Leadership and a
leader at Prairie View High School, I will commit myself to an increased level of work,
including significant time commitments before and after school, and during weekends. I
also recognize that I must be a good example for students and will be held to a higher
standard with regard to behavior, attendance, and grades. I understand that if I do not
meet these expectations as determined by the advisor, I may be dismissed at any
time from the class. By signing below I acknowledge I understand the level of work and
commitment required by Leadership.
Signature: ________________________________________________________________________
Date: _________
Parent/Guardian Understanding of Level of Work and Commitment
I, _______________________________________, parent/guardian of _______________________________________,
understand that as a member of Leadership and a leader at Prairie View High School, my
student will commit themselves to an increased level of work, including significant time
commitments before and after school, and during weekends, and that as their
parent/guardian will need to assist in facilitating this participation. I also recognize that my
student must be a good example for students and will be held to a higher standard with
regard to behavior, attendance, and grades. I understand that if my student does not
meet these expectations as determined by the advisor, he or she may be dismissed at
any time from the class. By signing below I acknowledge I understand the level of work
and commitment required by Leadership for my student and myself.
Signature: ________________________________________________________________________
Date: _________