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Access Application Form 2019

Please do not leave fields blank. Answer N/A

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* 1. Contact Information

Name: *

Address 1: *

Address 2: *

City:

Province/Country: *

Postal Code: *

Primary Email Address: *

Alt Email Address: *

Cell Phone #: *

Alt Phone #:

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* 2. What post-secondary institution do you attend?

SFU

BCIT

UBC

Douglas College

None Currently

Other

If other, please specify

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* 3. Educational Information

Program of Study

Specialization (if known)

GPA

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* 4. When will you be graduating from your program of study?

	Month	Year
Date of Graduation	Date of Graduation Month menu	Date of Graduation Year menu

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* 5. Why are you interested in the Access Program?

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* 6. Please describe some of your interests, hobbies, extracurricular activities, and/or volunteer experiences.

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* 7. There will be a student led, collaborative component to the program. Please indicate the types of "problem solving" you might be interested in:

Social Issues: I want to have input on helping to solve larger social issues or I am interested in giving back to the community,

Environmental Issues : This is top of mind for me and I would like to contribute to a solution in some way with my peers.

Case Competition: I would love to particpate in helping to create a "case competition" or participate in a case competition where my peers and I are asked to present a solution to a real business problem.

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* 8. How did you hear about this program?

Word of Mouth

Student (Set) Rep

Campus Club

Event

School Faculty

Web

Other (please specify)

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* 9. Please review the following commitments of our program, which will be required of you if you are accepted.

i. Attendance at both orientation and graduation is mandatory.

Orientation will be early November.

Graduation date to be announced.

ii. Ability to attend, in person, the minimum required number of events, workshops, and mentor meetings is a must.

You must attend a minimum of 3 mentor meetings, 2 peer planned workshops and 2 BBOT events to complete the program.

If you choose to participate on a committee you must attend at least 90% of the meetings and finish the program in good standing which will be judged by your committee chair and fellow committee members.

iii. Missed mandatory requirements will mean in-completion of the program.

Yes, I understand and agree.