Iowa Central Commuity College

Student Ambassador Application

Fill out the form below to apply for membership in Iowa Central's Student Ambassador program.

Questions about this application please reach out to:

Jordyn St John
stjohn@iowacentral.edu
515-574-1007

* indicates a required field

Contact Information
* First Name: A value is required.
* Last Name: A value is required.
* Address: A value is required.
* City: A value is required.
* State: A value is required.
  Zip:
* Email: A value is required.Invalid format.
* Phone: A value is required.Invalid format.
* Date of Birth: A value is required.Invalid format.

Education Information
* Which Program/Major is of most interest to you? Please select an item.
* High School: A value is required.
* Cumulative GPA: A value is required.
* Graduation Year: A value is required.
* Semester Applying for: Please select an item.

Experience/Skills
  Are you bilingual? If so, please list the languages (other than English) that you are able to read/write/sign:
  List school, church, and community activities in which you have participated (list offices and leadership roles you have held):
 

List work/job experience (paid or unpaid):

 

List any honors, scholarships, or awards you have received:

 

Why did you choose to further your education at Iowa Central?

 

In your opinion, what are five factors that influence a student’s college decision:

 

List three personal qualities you possess that would enable you to be an effective Student Ambassador:

  Why do you want to be an Ambassador?
  Were you recommended by an Iowa Central staff member? If so, who?:
  Please list at least one reference (not related) we can contact if necessary:

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