Dean's Dozen

School of Education, Health and Human Behavior


For additional information regarding the role of the Dean's Dozen and the selection process, please plan on attending the informational meeting: Monday, October 6, 2014  at 3:30 pm in
FH 1322

Please type in the space provided


2. Permanent address if different from current:

3. Are you a full time (12 semester hours) SIUE student?

4. Number of hours that will be completed prior to the Spring 2015 semester:

5. Class Rank:

6. Cumulative GPA:

7. Check the area of declared major:



8. Please indicate your minor (or content area for Secondary Education students):

9. Are you presently employed?

10. If  you are employed, please complete the following:

11. Most relevant work experience (if different from above):

12. Please list any Leadership roles, experience and service participation you've had during your college years (include any organizations, community activities and/or volunteer or service experience).
Organization/Activity Position/Role Duration (start/end dates)

13. How would you represent the diversity of students and programs within the School of Education at SIUE?
(200 words or less)

14. What will be your unique contributions to the Dean's Dozen if selected (200 words or less)?



15. Please include two names and telephone numbers of faculty from the School of Education, Health and Human Behavior who would recommend you: