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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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Miami Dade College is accredited by the Southern Association of Colleges and Schools Commission on Colleges to award associate and baccalaureate degrees. Contact the Commission on Colleges at 1866 Southern Lane, Decatur, Georgia 30033-4097 or call 404-679-4500 for questions about the accreditation of Miami Dade College.
Miami Dade College is an equal access/equal opportunity institution and does not discriminate on the basis of gender, race, color, marital status, age, religion, national origin, disability, veteran's status, sexual orientation, or genetic information. Contact the Office of Equal Opportunity Programs/ADA Coordinator, at 305.237.2577 for information.
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