BROCK UNIVERSITY. Board of Trustees Spirit of Brock Medal. Description

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BROCK UNIVERSITY Board of Trustees Spirit of Brock Medal Description The Board of Trustees Spirit of Brock medal is intended to recognize those students who best exemplify the spirit of Sir Isaac Brock. The medals will be presented to the graduating recipient(s) at the convocation ceremonies held in the spring and fall. Students who demonstrate any one or more of the following qualities can be recommended: Leadership Courage Innovation Inspiration Community Involvement Graduating students may apply to the Office of Student Accounts and Financial Aid who will ensure the applications review by their respective Deans/Faculty Awards Committees. The awards will be made on the recommendations of the Deans of Applied Health Sciences, Business, Education, Humanities, Mathematics and Science, Social Sciences and at the graduate level (Masters and PhD) the Dean of the Faculty of Graduate Studies in consultation with the Deans of Applied Health Sciences, Business, Education, Humanities, Mathematics and Science, Social Sciences. Nominations will be sent to the Office of the Student Awards and Financial Aid by a deadline that will be determined annually. Guidelines and Criteria: Spring Convocation Medals: The students who receive this Medal must be from the graduating class, one each recommended by the Deans of the Faculties of Applied Health Sciences, Business, Education, Humanities, Mathematics and Science, and Social Sciences, and students graduating from the Faculty of Graduate Studies, recommended by the Dean of the Faculty of Graduate Studies in consultation with the Faculty Deans, one each from Applied Health Sciences, Business, Education, Humanities, Mathematics and Science, and Social Sciences, for a total of 12 recipients. Fall Convocation Medals: The students who receive this Medal must be from the graduating class, one undergraduate recommended by the Deans of the Faculties of Applied Health Sciences, Business, Education, Humanities, Mathematics and Science, and Social Sciences, and one graduate student graduating from the Faculty of Graduate Studies, nominated by the Dean of the Faculty of Graduate Studies in consultation with the Deans of Applied Health Sciences, Business, Education, Humanities, Mathematics and Science, and Social Sciences, for a total of 12 recipients. Students must submit a signed and dated application form. Additional documentation may be attached to your application. Completed applications must be submitted by the specified deadlines.

Board of Trustees Spirit of Brock Medal APPLICATION FORM: Student Candidate Name: Student I.D# Home Address: Postal Code: Telephone: e-mail address: Student Signature: Additional documentation is attached in support of this Application: In Person: Brock Central @ the Registrar 3 rd floor, Schmon Tower. Mailing: Please submit signed and dated Application Form to: Student Financial Services Room 402, Schmon Tower Brock University St. Catharines, ON L2S 3A1 Deadline: Applications must be received by: Spring Convocation: Last Friday in March Fall Convocation: First Friday in September Yes No Original signed applications are due by 4:30 pm at Student Financial Services, Schmon Tower 402. Complete or part applications, as well as faxed, emailed, electronic or late portions will not be accepted. Only original signed applications are accepted; no exceptions. If you are utilizing courier services to send: a complete, original, signed application; consider the travel and internal delivery time of the application. If the application is being couriered, give at least 1 week for it to arrive at its final destination at Brock. Permission: By submitting an application, you give full permission for your name, and information provided within to be supplied to third parties. 2

Candidate Information List involvements where you feel you have demonstrated the spirit of Sir Isaac Brock in one or more of the required areas listed: leadership, courage, innovation, inspiration, community involvement Please Type: Description\Involvement Position(s) Held Dates of Involvement Invested Time Commitment Achievements\ Accomplishments Paid Position (Y/N) Relate d to a Course (Y/N) Additional Information: [Additional Documentation may be attached in support of this application] 3

Endorsement Candidate: Please have this section completed by a Referee. This person should have comprehensive knowledge of your various involvements with respect to the required areas of excellence. Referee may attach additional sheet if necessary. Referee: Name: Address: Telephone: I have known the candidate for the period of: Title: Postal Code: e-mail address: to: Please speak to the candidate s achievements and involvement in the following areas: o Leadership o Courage o Innovation o Inspiration o Community Involvement Signature: 4

Personal Statement Candidate: In the space below, please submit a personal statement detailing for the Dean/Selection Committee your suitability for this award. Please speak to your achievements and involvement in the following areas: o Leadership o Courage o Innovation o Inspiration o Community Involvement Signature: 5