APPLICATION FOR LEADERSHIP AND SERVICE AWARDS SURVEY FORM

Name of Cooperating School: _________________________________________________________________________

Instructions: Kindly read the following criteria and fill up the form carefully.

LEADERSHIP AWARD
Leadership Award is given to any graduating student based on his/her exemplary leadership contribution to the College. The applicant should
follow the following criteria:
1. The candidate must be a Central Student Government (CSG) Officer, Student Body Organization (SBO) Officer or club or sub-
organization officer for at least 2 years.
2. The candidate must have exhibited exemplary achievements as a leader in all the co-curricular and extra-curricular activities.
3. Must have no failing marks, INC or DA.
4. Must have no violations in any of the Code of Conduct as stipulated in the Student Handbook.

For Leadership Award

Name Position of Year Activities
CSG/SBO/club
Ex. Juan dela Cruz CSG President 2021 Facilitated all student related activities during this year.
CSG President 2022 Facilitated all student related activities during this year.

Note: Submit any proof of evidence of your designations and positions e.g. certificates, letters, pictures etc. to the Program Head

SERVICE AWARD
Service Award is given to any graduating student based on his/her notable service rendered t the College where he belongs and to the school in
general. The applicant should follow the following criteria:
1. The candidate MAY OR MAY NOT BE a Central Student Government (CSG) Officer, Student Body Organization (SBO) Officer or
club or sub-organization officer
2. The candidate must have rendered notable service to the College where he belongs and to the school in general
3. Must have no failing mark/s, INC or DA
4. Must have no violations in any of the Code of Conduct as stipulated in the Student Handbook.

For Leadership Award

Name Name of the Activity Year Tasks
Ex. Juan dela Cruz Foundation Day 2021 Coordinator-Fun Run

Note: Submit any proof of evidence of your designations and positions e.g. certificates, letters, pictures etc. to the Program Head
(Reference: SaCC Student Handbook, 2024 Edition)