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Today's Date: __________________

 

Name: _________________________            Student #: ______________

 

Address: ____________________________________________________

 

Home Ph #: ____________                     Beeper #: ______________        

 

Work Ph#: _____________                   Cell Ph#:    ______________

 

Email: ________________________

 

Program of Study: _______________________

Expected Graduation Date: _______________

 

 

What Talents, skills or ideas do you want to bring to the Medical Campus SGA?

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________ 

 

Are you willing to participate in any student activities? Yes ___   No ___

 

All applicants must be currently enrolled in at least 6 credits at the MedicalCampus & have a minimum GPA of 2.0.

President and Vice President must have a minimum GPA of 2.5. Please attach a copy of your degree audit and current class schedule.

 

Submit application to Student Life/ SGA, Room 1171

   
   
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