The Office of Student Leadership & Involvement
West Chester University of Pennsylvania

 

 

Certified Student Leader
Information Form

Personal Information

Name

WCU ID #

Campus/Local Address

Local Phone

Home Address

Home Phone

Email (preferred)

Birthday

Sex

Education Information

Number of Years at WCU

Anticipated Graduation Date

Academic Major/Minor

Other Colleges Attended

List activities currently involved in at WCU. Please include work and community service activities. List any positions held.



 

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