1. Healthcare

APPLICATION FORM
ADMINISTRATIVE INFORMATION
ELIGIBILITY
Undergraduate students may apply to the Peter Lougheed Leadership College, if they meet the following eligibility
requirements:
1) Students must have completed a minimum of *51 and a maximum of *69 towards their current degree including courses in progress during the Winter term in which they apply;
2) Students must have a minimum GPA of 3.3 at the time of application;
3) Students must be current University of Alberta undergraduate students, or transfer students who have applied
for entry to a degree program;
4) Students can enroll in the Certificate in Interdisciplinary Leadership Studies from the Peter Lougheed Leadership College only once.
Limited space exists in the Peter Lougheed Leadership College. Priority will be given to applicants who meet the
above eligibility requirements. At the discretion of the principal, other applicants will be considered; however, under
these circumstances, applicants must contact the college in advance of submitting their application.
Admission decisions will be made by Peter Lougheed Leadership Admissions Committee on the basis of the
student’s character and leadership potential based on a combination of a personal interview, resume, personal
statement and letters of reference.
Students are encouraged to consult with an advisor in their Faculty to ensure that the Peter Lougheed Leadership
College program will fit with their current program.
RESIDENCE
The Peter Lougheed Leadership College program provides an opportunity to live in residence with the PLLC cohort
or to participate as a non-resident. While Peter Lougheed Hall is being constructed, PLLC Scholars will reside in
Schaffer Hall (within Lister Centre).
Peter Lougheed Leadership College applicants who are accepted into the college and apply to live in residence by
April 30th are guaranteed a space in residence. Please visit residence ualberta.ca/OurResidences/SchafferHall
for more information.
DEADLINE
Applications will be accepted on a continuous basis until MARCH 31, 2015.
There is no application fee for the Peter Lougheed Leadership College.
Send completed applications to:
Peter Lougheed Leadership College
2-24 South Academic Building (SAB)
University of Alberta
Edmonton, AB T6G 2G7 APPLICATION FORM
CHECKLIST OF
ITEMS REQUIRED
FOR SUBMISSION
APPLICANT PERSONAL INFORMATION
Salutation
First Name
Middle Name
Surname
This completed page included
as the covering page of
application form
Mailing Address
RESUME
City
Postal Code
LETTERS OF REFERENCE
(Two required)
Permanent Address (if different than the above)
City
Postal Code
Phone Number
Email
I HEREBY CERTIFY that the information contained in this application is complete and
correct in all respects. I authorize the Peter Lougheed Leadership College to confirm
information contained in this application as necessary.
The personal information requested on this form is collected under the authority of
the Universities Act and Section 32 © of the Alberta Freedom of Information and
Protection of Privacy Act for the purpose of determining eligibility for the Peter Lougheed
Leadership College.
Signature of applicant
OFFICIAL TRANSCRIPT
OF GRADES (from current term)
Date
One letter must be from a member
of the University of Alberta academic
staff (or current post-secondary
institution for transfer students) and
the other from an individual familiar
with the student’s extra-curricular
activities.
RESIDENCE
I am interested in living in residence
at Schaffer Hall
PERSONAL STATEMENT
The Personal Statement must
outline the student’s reasons for
wanting to enter the Peter Lougheed
Leadership College and the student’s
assessment of why he or she is an
ideal candidate for the program.
The student should discuss what
he or she hopes to achieve through
the program and how he or she will
contribute to the success of the
program. This statement is not to
exceed 500 words.