Impact Rice Retreat 2010 -Participant Application 


The Impact Rice Retreat is an annual weekend leadership forum sponsored by the Officeof Student Activities. The retreat strives to empower students by fostering the leadership skillsnecessary to affect change at Rice and beyond. It is organized and run by students dedicated toimproving all aspects of the Rice community. The student staff members are former retreat 
participants themselves.

During your weekend at Camp Allen, January 15-17, you will participate in discussions 
about campus issues, get tips on how to network and get things done at Rice, and develop yourown personal visions. We hope you will consider participating in this incredible opportunity tomeet and interact with other diverse and inspiring student leaders. 

Submit your application to the Office of Student Activities in the RMC Cloisters by 5:00pm onFriday, October 30th . 

E-mail the student coordinators Peter Steffensen (psteff@) and Mary Draper (maryd@) with any 
questions or concerns. 

Name: College: 

Email: Telephone: 

Major(s): Gender: 

Class (FR/SO/JR/SR): T-Shirt Size: 

Please list the activities and organizations that you are actively involved in: 

*Mailing Address: (if off-campus): 

*Mailing Address and phone number (during holidays): 


Impact Rice Retreat 2010 Application Questions

Typed applications are preferred so please create a new document.
Please make sure everything is numbered and that all of the questions are included. 


1. Describe a situation in which you demonstrated leadership. Why would you categorize it asÒleadershipÓ? 
2. Choose one activity or organization that you are, or hope to be, involved in. How do you seeyourself impacting that activity/organization in the long term? 
3. Why did you choose to apply for the Impact Rice Retreat? 
4. What is one issue on Rice campus you would like to see addressed and why? 
5. What leadership skills would you like to develop on the retreat, and how will you share 
those skills upon your return to Rice? 
6. Imagine yourself at graduation, what do you want to say you accomplished during your timehere? 
7. Write a haiku about yourself. (A haiku is 3 lines. The first and third lines are 5 syllables, and 
the second line is 7 syllables. It does not need to rhyme.) 
8. Fill in the box with something that appeals to you. (It does not need to be elaborate.) 
Remember to do the following:

¥ 
Deliver this application to the Office of Student Activities (MS 527) in the RMC Cloisters. 
¥ 
Email Mary (maryd@) and Peter (psteff@) with any questions or concerns. 
The application deadline is 5:00pm on Friday, October 30th. The retreat dates 
are Friday, January 15th (in the evening) through Sunday, January 17th (late 
afternoon).