Name:___________________________________________________________________________________
Address:__________________________________________________________________________________
City:__________________________ State:___________________ Zip Code:__________________________
Cell Phone:(______)__________________E-Mail Address:_______________________________________
Can we contact you by Facebook or Twitter? If so, please list your username/email.
Facebook_____________________________________________
Twitter_______________________________________________
High School Attended:______________________________________ Date of Gradution________________
Major Field of Study at Schoolcraft College:_________________________________
Credit Hours Completed:_________________ Credit Hours Presently Enrolled:_________________________
Anticipated time remaining at Schoolcraft College?_______________________________________________
What activities would you be interested in?
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
__________________________________________________________________________________________
Signature:_____________________________________________ Date:____________________________
Please return completed application to the Student Activities Ofce, located in the Lower Waterman Campus Center.
It is the policy of Schoolcraft College that no person shall, on the basis of race, color, national origin, gender, age, marital status, creed or handicap
be exluded from participating in, be denied benets of, or be subjected to discrimination during any program or activity or in empolyment.
Are you currently employed? Yes No
Are you currently involved in any other extracurricular activities? Yes No
If yes, please specify:________________________________________________________________________
Best day and time for you to attend meetings:
Monday: _________ Tuesday: _________ Wednesday: _________ Thursday: _________ Friday: _________
Student Nurse Association
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Membership Application
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