MUHAMMAD ALI CENTER COUNCIL OF STUDENTS (M.A.C.C.S.)
APPLICATION
Please complete this application and return it to:
Muhammad Ali Center
Education Department
144 N. Sixth Street
Louisville, KY, 40202
Name: ______________________________________________________________________
Parent/Legal Guardian’s Names________________________________________________
Address: _____________________________________________________________________
City: ______________________________________ Zip Code _________________________
Home Phone: _________________________ Cell Phone: ___________________________
E-mail Address: _______________________________________________________________
School: ___________________________________________ Grade ____________________
Date of Birth ______________________________________
Please use additional paper if needed to answer these questions:
In what school and community activities / organizations do you participate?
Please describe your involvement and experience with volunteer work and community service.
Why would you like to be part of the Muhammad Ali Center Council of Students?
How did you hear about this program?
Being a MACCS member requires a minimum commitment of 5 hours a month. Some months will require more time based upon the events and activities scheduled. Are you willing to attend monthly meetings and participate in service projects?
YES ____________ NO ____________
List your interests & activities (hobbies, organization, clubs, sports)
I understand that if I am selected as a member of the Muhammad Ali Center Council of Students I will need to attend monthly meetings, participate in service projects and volunteer activities, and behave in a manner that upholds Muhammad’s six core values of Respect, Confidence, Conviction, Dedication, Spirituality, and Giving.
________________________________________ _____________________
Student Signature Date
I, __________________________, give permission for _____________________________ to
Parent Name Student Name
apply for the Muhammad Ali Center Council of Students. If selected, I will support him/her in attending meetings, functions and participating in service projects.
__________________________________________ ____________________
Signature of Parent or Guardian Date
MUHAMMAD ALI CENTER COUNCIL OF STUDENTS (M.A.C.C.S.)
APPLICATION ESSAYS
Please select a core value; Respect, Confidence, Conviction, Dedication, Spirituality, or Giving, and discuss the role it has played in your life.
One of Muhammad Ali’s six Core Values is Confidence. Having confidence helped Ali become the Greatest, and gave him
the courage to tell the world about his greatness. Breifly describe one thing that makes you great.
MUHAMMAD ALI CENTER COUNCIL OF STUDENTS (M.A.C.C.S.)
Letter of Reference
(Please obtain a reference from someone outside of your family)
Please use additional paper if necessary.
Applicant’s Name _______________________________________________________________
Reference’s Name ______________________________________________________________
Address ______________________________________________________________________
City, State, Zip _________________________________________________________________
Home phone _____________________________ Work Phone __________________________
E-mail ________________________________________________________________________
How long have you known the applicant?
What is your relationship to the applicant?
Is the applicant dependable?
Why would you recommend the applicant for this position?
_________________________________________________ _______________________
Signature of Reference DATE