Western Leadership for Global Impact Application Form

Western Leadership for Global Impact Application Form

Thank you for your interest in the Western Leadership for Global Impact Summer Program.

This two-week residential program brings together a select group of internationally minded students to explore leadership, sustainability, innovation, and global citizenship while experiencing life at one of Canada's leading universities.

Participants will collaborate with peers from around the world, tackle real-world challenges, strengthen their leadership and communication skills, and develop solutions to create positive change through the Global Impact Challenge.

We are looking for students who demonstrate curiosity, initiative, collaboration, and a desire to make an impact.

Before beginning your application, please ensure you meet the eligibility requirements and are prepared to complete the short written responses included in the application.

Dates: August 1-14, 2027
Location: Western University, London, Ontario, Canada
Eligibility: International students in Years 10 and 11. Students must be 16 years of age by the first day of the program.
Format: Two-week residential summer academy

We look forward to learning more about you.

Before You Begin: To help make the application process as smooth as possible, please review the requirements and gather all necessary information and documents before starting. This application must be completed in one sitting and cannot be saved for later completion. We recommend preparing your short-answer responses in a separate document before submitting your application.

1Student Application > 2Final Review & Submission
Student Name Student Name First Last
Preferred Name (optional)
Date of Birth Date of Birth / MM / DD YYYY
Country of Citizenship
Country of Residence
Current School
Current Grade Level

Current Grade Level Year 10 Year 11
Expected Graduation Year
Email
Phone
Parent and Guardian Information

As this is a residential program for students under the age of 18, parent or guardian information is required to support communication, program administration, and student wellbeing before and during the program.
Parent/Guardian Name Parent/Guardian Name First Last
Relationship to Student
Parent/Guardian Email
Parent/Guardian Phone Parent/Guardian Phone - ### - ### ####
Emergency Contact Name Emergency Contact Name First Last
Emergency Contact Phone Emergency Contact Phone - ### - ### ####
Emergency Contact Email
Academic Information

To help us understand your educational background and ensure you are prepared to participate fully in the program, please provide the information below. Academic performance is considered as part of the application process, but we also value leadership potential, curiosity, engagement, and a willingness to learn.
What is your current overall academic average?

What is your current overall academic average? 90%+ 85-89% 80-84% 75-79% Below 75%
How would you rate your English proficiency?

How would you rate your English proficiency? Beginner Intermediate Upper Intermediate Advanced Native/Fluent
Please upload your most recent school report card or transcript:
Leadership & Global Impact

At Western Leadership for Global Impact, we are looking for students who are curious about the world, eager to learn from others, and motivated to make a positive difference in their communities. The following questions will help us learn more about your interests, experiences, perspectives, and aspirations, as well as how you hope to contribute to and benefit from this program.
What interests you most about participating in the Western Leadership for Global Impact program, and how do you hope this experience will contribute to your personal, academic, or future goals?

(Maximum 300 words)
Describe an issue, challenge, or opportunity in your school, community, or the world that matters to you. Why is it important, and what role do you think young people can play in creating positive change?

(Maximum 300 words)
Tell us about a time when you demonstrated leadership, initiative, or collaboration to achieve a goal, solve a problem, or support others. What did you learn about yourself through the experience?

(Maximum 300 words)