Student Application Form - Public Service Scholars Program

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Public Service Scholars Program
Spring 2010 Application
CSU undergraduate students wishing to participate in the Public Service Scholars
Program must fill out and submit the following application materials. A complete
application includes the following items (please check off each item to indicate its
inclusion in your application and that you can attend the retreat in January).
_____
_____
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Application Form (below)
Short Essay Responses
I can attend the Program retreat on TBA date in January 2010.
The application deadline is Thursday, October 15th, 2009, at 5 p.m. Please
complete and submit these materials to the Office of Service-Learning, TILT, 801
Oval Drive, Room 146, or email them to: clayton.hurd@colostate.edu.
For more information please contact Clayton Hurd, Director of Service-Learning in
The Institute for Learning and Teaching (TILT) at 491-2032 or
clayton.hurd@colostate.edu, or consult the website at
http://tilt.colostate.edu/sl/pssp.cfm.
Public Service Scholars Program: Student Application Information
Name: _____________________________________________________________
Student Identification No. (CSU ID): _____________________________________
Major(s), minor(s): ___________________________________________________
E-mail Address: _____________________________________________________
Street Address: _____________________________________________________
Phone Number: ___________________________________
Expected Graduation Date (Semester/Year): ____________
Current Year and GPA:_______________________________
Have you been a member of a CSU Learning Community or Living-Learning
Program(s)? (If so, please list.)
____________________________________________________________
Program Overview
The Public Service Scholars Program is an interdisciplinary, non-residential learning
community designed to provide undergraduate students with the academic and
socially-responsive skills to understand and participate in community leadership and
public scholarship designed to contribute to social change in a global context.
Specifically, the PSSP is designed to support 2nd and 3rd year students interested in
linking their passion for social change and community involvement with advanced
academic work in their major of study. The program is a two-semester experience
intended to provide students from across the disciplines with the knowledge and
skills to imagine and develop senior-level research, thesis, design, capstone or
other projects that focus on service-learning and social action scholarship.
During the first semester of theoretical learning (Spring 2010), PSSP participants
will engage intellectually and experientially with significant social and public issues
(civil rights, education, environmental, public health, human rights, youth
development, poverty, sustainable development, etc.) on a global scale. In the
second semester (Fall 2010) students will enroll in a one-credit seminar focusing on
research strategies related to community-based, social action scholarship. During
the program each participant will participate in equivalent of a one-semester
service experience
(internship, practicum, or independent service or field
experience) with an organization of their choice that dedicated to service and social
change at the local, national, and/or global levels. Through an integration of
academic, experiential, and public service components, students will have
opportunities to develop and realize their potential for social action public
scholarship/ research at the local, national, or global level. The overall program is
designed to make participants more fully aware of their potential to use their
intellects, as well as their hearts, to better society.
Program Eligibility Guidelines


Admission to the Public Service Scholars Program is open to all current CSU
2nd year and 3rd year undergraduate students, in any major
Students must be in good academic standing with Colorado State University
Program Expectations
Every Public Service Scholar student is expected to:
1. Successfully complete the two-semester course sequence [IU 280 (Spring
2010 - 3 credits), IU 281 (Fall 2010 - 1 credit)] specifically designed for the
Public Service Scholars Program;
2. Complete the equivalent of a one-semester service experience (internship,
practicum, or independent service or field experience) with a government,
non-profit or nongovernmental organization of their choice that is dedicated
to service and social change at the local, national, and/or global levels;
3. Demonstrate clear progress in and accomplishment of key Program goals and
personal competencies;
4. Participate in and assist in organizing Public Service Scholar Program events
and activities.
If accepted, I agree to uphold the expectations of the Public Service Scholars
Program by participating actively and regularly in its functions and programs. I
pledge that I will commit the time and energy needed to make the Public Service
Scholars Program successful for my peers and me. Yes, I understand the
expectations for participation in this program, if I am accepted and choose to join
the program. I further recognize that failure to fulfill these expectations could affect
my academic status in the Public Service Scholars program.
___________________________________________
Student Signature
_____________
Date
Essay Questions (required)
On separate sheet of paper, please briefly answer the following four essay
questions. Please limit your answer to approximately 150 words for each question.
1. Why are you applying to the Public Service Scholars Program? How will the
PSSP enhance your educational and career goals?
2. What critical issue(s) or problem(s) are you most interested in addressing?
Why?
3. What experiences and skills can you bring to the learning community?
4. How have you contributed to your community through service experiences?
(i.e., an internship, service learning, or volunteering in the community)
Faculty/Community Mentor (optional)
Who might you like to choose as a faculty/staff/community mentor?
(Naming a specific mentor is not required for acceptance t to the program.)
Mentor Name
Affiliation (organization or department)
Title
Email/Phone
Submission of Applications
To ensure the full consideration of your application to the Public Service Scholars
Program, please complete and submit these materials by 5 p.m. on October 15th,
2009, to the Office of Service-Learning, TILT, 801 Oval Drive, Room 146, or
email them to: clayton.hurd@colostate.edu.
If you are mailing your application (via campus or U.S. mail), please send
it to:
ATTN: Dr. Clayton Hurd, Director of Service-Learning
Office of Service-Learning
The Institute for Learning and Teaching (TILT)
Campus Delivery #1052
Colorado State University
Fort Collins, CO 80523
If you have any questions, please contact Clayton Hurd, Director of Service-Learning at
clayton.hurd@colostate.edu or 491-2032.
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