_________________________________________________________________________________
_________________________________________________________________________________
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PERSONAL INFORMATION – PLEASE PRINT CLEARLY. Applications that cannot be understood will
be discarded. Please provide academic transcript with application and a RECENT photo with application.
You are required to participate in a
virtual interview with the SGA Election Committee. Please wear
business attire for the interview.
Name: ___________________________________________________________________________
Local Address: _______________________________________ Local Phone: _______________
Home Address: _________________________ Home Phone: _______________________
Email Address:__________________________ Student ID:__________________________
Semesters Remaining at LDCC: _____
Grade Point Average 2.0 or above? YES NO
Major: __________________________________________________________
ACTIVITIES/INTERESTS
Please list all co-curricular activities you have participated in and any offices that you have held.
(Use back side or separate sheet if necessary)
GENERAL QUESTIONS
Please answer on a separate sheet of paper. If hand written, please make sure that it is legible.
1. Why are you interested in being a Student Senate Representative and how does this position
relate to your college goals?
2. What are your qualifications for this position?
3. How will the students at your campus benefit by having you represent them as their Senator?
By signing below, I acknowledge that all of the information contained in this application is accurate and
is my own work.
Name (printed): ______________________________________
N
ame (signed):
_____________________________________ Date: ________________________
I
nterview Date:__________________________
Approved: _________ Denied: __________ Date: ____________
03012020
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