Application Form for Inclusion on the
Dean of Students’ Roll of Honour 2011
The Dean of Students’ Roll of Honour recognises the learning gained through involvement
in extracurricular, voluntary activities and acknowledges the contribution which this learning
process has allowed an individual make to his/her organisation or peers, or the College or
another community. Voluntary activity is an all embracing concept which encompasses
unpaid formal and non formal, social, cultural, political, inter personal and caring activities.
All students who have dedicated a minimum of twenty hours to any form of extracurricular
voluntary activity within a single College year are eligible to apply for inclusion. In
exceptional circumstances, this requirement may be waived by the panel processing the
applications
Name:
Student Number:
Address:
Phone:
Email:
Programme
of Study:
Stage of Study:
e.g. JS, SF, PG
Activity:
In submitting this application form, I confirm that I have completed the application form in
full and that the responses provided are my own and accurately reflect the learning I have
gained through my involvement in extracurricular voluntary activity. To the best of my
knowledge, all information within this application is accurate and correct.
Signed:
Date:
Please note that Section A must also be signed by an officer or representative of the group
with whom you undertook the activity described or by a peer who is in a position to verify
this work.
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Section A
Describe the voluntary activity in which you have been engaged.
Description should include i) the nature of the activity, ii) the time dedicated to this activity
by the applicant, iii) the applicant’s role/responsibilities in the organisation/group, iv) the
impact of the activity on his/her organisation or peers, or the College or another community.
Where relevant, the applicant may also describe how s/he demonstrated leadership and/or
initiative and any way in which s/he contributed to the development and sustainability of the
organisation and/or community with whom s/he worked (400 words max).
I confirm that the applicant has contributed twenty hours or more since April 2010
and that the description in Section A (above) is a true and accurate account of the
applicant’s involvement with our group/organisation.
Signed:
Position within
Org/Relationship
to Applicant:
Group/
Organisation:
Date:
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Section B
Compare your experience with your own original expectations & personal objectives.
In this section, the applicant should reflect on how realistic his/her expectations were when
first engaging in the activity. The applicant may wish to take any or all of the following into
account: the practical skills developed through the activity; any challenges encountered;
his/her perception of the importance of his/her contribution and how this was valued by the
organisation/group and, where appropriate, by the College and/or wider community; the
positive and negative aspects of engaging in this activity for the applicant (500 words max).
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Section C
Describe the learning which took place as a result of engaging in this activity.
Description should include i) what the applicant has learnt e.g. in relation to the
development of skills, working as part of a team, work ethos, work structures, the value or
otherwise of engaging in extracurricular, voluntary activities, personal strengths and
weaknesses and how s/he has developed as a person as a result of engaging in this
activity; ii) how the applicant has learnt this, e.g. through peer learning, mentoring,
research, self reflection, trial and error; iii) what the significance of this learning is; iv) how
this learning will be carried forward or used in the future and v) what goals for improvement
s/he will set for him/herself (500 words max).
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