Before you get Started

Thank you for your interest in applying for this award. All complete and on time applications will be accepted and reviewed by the adjudication committee. Please note the following:

This is a two part application. You can find an application guide here on what you will need to complete part one and two. The form on this page represents part one of the application. You will be advised upon submission of this form how and where to complete part two.
By applying for this Brock University Award, you must also agree that if you are the successful candidate, you agree to be nominated for the Experiential and Work-Integrated Learning Ontario (EWO) Experiential Learning (EL) Student of the Year Award and/or the Work-Integrated Learning (WIL) Student of the Year Award, and the Co-operative Education and Work-Integrated Learning (CEWIL) Canada University WIL Student of the Year Award.

Application Deadlines

Part One Submission Deadline: December 6th, 2024 at 11:59 p.m.

Part Two Submission Deadline: December 13th, 2024 at 11:59 p.m.

Questions? Need Help?

Please reach out to your Experiential Education Coordinator for your faculty. Not sure who to contact, please visit the Co-op, Career and Experiential Education Contact Us page to find the right contact.

Nomination Information

Thank you for your interest in applying for the Brock University Experiential Education Student(s) of the Year Award. There is a two-step application process. Once you have completed this application, you will be requested to provide additional information to complete your application.

Is this a nomination for an individual application, or for a group application?(Required)

Individual Application

Group Application

Student's Legal Name(Required)

First Last Student Number

Team Leader's Name(Required)

First Last Student Number

Phone Number(Required)

Brock Email Address(Required)

Mailing Address as of December of the current year(Required)

Street Address Address Line 2 City Province Postal Code

Additional Team Member's Information(Required)

First Name

Last Name

Student Number

Brock Email Address

Supporter Information

This application must be supported by at least one of the following: Community partner/supervisor, Experiential Education staff member, or faculty member

Who is the supporter of this application (check all that apply)(Required)

Community Partner/Supervisor

Experiential Education Staff Member

Faculty Member

I confirm that I have spoken with the supporter(s) listed below and confirmed that they are aware of this application.(Required)

Yes

All supporters will be contacted for additional information.

Community Partner/Supervisor Name(Required)

First Last

Organization Name(Required)

Job Title(Required)

Work Phone Number(Required)

Work Email(Required)

Address(Required)

Street Address Address Line 2 City Province Postal Code Country

Experiential Education Staff Member Name(Required)

First Last

Name of Faculty(Required)

Faculty Member Name(Required)

First Last

Name of Faculty(Required)

Faculty Member Email Address(Required)

Experience/Project Information

Name of Experience(Required)

Course Code(Required)

Faculty Member Responsible for the Project(Required)

Prefix First Last

Student Biographical Statement (300 word max)(Required)

Tell us a bit about who you are and your role as a student on the Brock campus. A highlighted summary of your contributions to the Brock, Niagara and/or broader communities

Describe the experience/project that you participated in (300 words max)(Required)

What did you do? Did you work with a community partner? What was the outcome?

If the Application meets the eligibility requirements for the Co-operative Education and Work-Integrated Learning Canada (CEWIL) Student of the Year Award, and/or the Experiential & Work Integrated Learning Ontario (EWO) Student of the Year Award, I/we give permission to be nominated by Brock University, and to allow CEWIL and/or EWO to use non-confidential materials for promotional purposes.(Required)

Yes

Phone

This field is for validation purposes and should be left unchanged.

Brock University protects your privacy and your personal information. The personal information requested on this page is collected under the authority of The Brock University Act, 1964, and in accordance with the Freedom of Information and Protection of Privacy Act (FIPPA). The information provided will be used by the University to support your interest in working with Career, Co-op, and Experiential Education (CCEE).

Welcome to Brock University

Information for

Academics

Research

About

Quick links

Want to go to Brock but not sure where to start? We can help.

How to apply

Our programs

Our campus

More information

Co-op, Career and Experiential Education

In this section

Experiential Education Student(s) of the Year – Application

Before you get Started

Application Deadlines

Questions? Need Help?

Nomination Information

Supporter Information

Experience/Project Information

Helpful links

Connect