Student Activities Board
Committe e Me m b e rs hi p Appl i c a ti on
N a me :
T#:
Current Address:
E - ma i l :
Phone#:
Program of Study at A rkansas Tech-Ozark:
I s y o u r c u m u l a t i v e G P A a mi n i m u m o f 2 . 2 5 ? ( i f a p p l i c a b l e )
Yes ____
No ____
Are you on disciplinary probation?
Yes ____
No ____
What other organizations in or outside Arka nsas Tech -Ozark have you been involved in?
Were you in a leadership position within any of the organizations? If so, please briefly explain your
role?
When do you plan to graduate Arkansas Tech -Ozark?
I do hereby declare my intention to run for membership of the Student Activities Board committee at Arkansas Tech
University-Ozark Campus. I give my permission for the Office of Student Services to release verification that GPA
requirements and qualifications have been met to the SAB advisor. I further understand and agree to attend meetings
Wednesdays at 3 p.m. Applications for membership are due Friday, Sept. 27, by 5 p.m. in the Student Services Office,
and selection will be held Sept. 30 through Oct 4. Students that have applied should campaign for elections. If have any
questions regarding the process email Faith Johnson, SGA Staff Advisor, at fjohnson5@atu.edu. Signing in the box below
verifies that you have read and understand this form, agree to the conditions of application, and that all information provided is
accurate.
Signature:
Date:
Application should be turned in to the Office of Student Services no later than
5 p . m. F r i d a y , S e p t . 2 7 , 2 0 1 3 .