IU South Bend Student Government Association Application
Please print, fill out, and submit a hard copy of this application to the
Director of Student Life, Scott Strittmatter, in SAC 201 on or before
12:00 p.m., Friday February 12, 2016 for one current vacant senate position.
Questions concerning the completion of this application should be directed to Holly
Klopfenstein, Chair of the Search and Screen Committee via email: hklopfen@umail.iu.edu
*Full Name: ___________________________________________
Address:
___________________________________________
*City:
_____________ *State: ________ Zip: ______________
IU E-mail:
___________________________ Student ID#: ___________________
Home Phone: _________________ Cell Phone: ___________________________
*Class Standing (Fall 2015):
___ Freshman ___ Sophomore
___ Junior
___ Senior
___Graduate student
*Position applying for:
President
Vice-President
Treasurer
Secretary
______Senator-at-Large
Expected Graduation Date: _______________________________
*Major(s): ______________________________________________
*Minor(s) or Certificate(s): ____________________________________________
Credit hours taking for Fall 2015: ____ Credit hours taking for Spring of 2016:
Previous Semester GPA
Cumulative GPA
Grade point averages and credit hours will be verified through a University Official.
P a g e | 1 *With which (if any) IU South Bend activities/clubs are you or have been involved?
*In which (if any) IU South Bend clubs are you an officer?
*Please list other activities and responsibilities outside of IU South Bend.
*What goals would you like to see accomplished with regard to IU South Bend campus life?
P a g e | 2 Requirements: •
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SGA members should expect to work, in total, about seven (7) hours per week. Senate, and Cabinet members shall have earned a cumulative grade point average of at least 2.5 on a 4.0 scale and maintain at least a 2.5 semester average while in office. Judicial Council (justices) shall have earned and maintain a cumulative grade point average of at least 3.0 on a 4.0 scale and maintain at least a 3.0 semester average while in office. Undergraduates shall maintain at least six credit hours during the semesters they hold office. Graduate students shall maintain at least three credit hours. Senate and Judicial members shall have completed twelve credit hours. Six of which must have been completed at Indiana University South Bend. Cabinet members shall be enrolled in at least six credit hours at Indiana University South Bend during the semesters they hold office. Senators shall serve at least two (2) office hours per week. Justice members must serve at least one (1) office hour per week. The Chief of Staff must serve at least two (2) office hours per week. The Director of Campus Affairs must serve at least one (1) office hour per week. By signing my name here, I certify that I meet all of the above requirements for successful candidacy, as well as meeting the requirements set forth in the SGA Constitution. I further certify that, if elected, I will fulfill my obligations to IU South Bend, the IU South Bend Student Government Association, and the IU South Bend student body. _____________ __________________________ Signature _____________________ Date P a g e | 3 Grade and Information Release By signing the following, I _______________________ authorize Indiana University South
Bend the right to verify and release my grade report and academic course load to Indiana
University South Bend Student Government, including the Executive Board Members and the
Search and Screen Committee. This information will only be used to verify the academic
requirements set forth in the Student Government Association Constitution. This release of
information will be in effect through the selection process till the end of my term with SGA, or
when I rescind this permit in writing.
I also authorize the Election’s Committee and the Office of Student Life to release some of my
information in this application to assist in the creation of a Candidate Information Resource to
help inform voters. Information that may be released is noted by an asterisk in front of the field.
______________________________________________________________________________
Signature
Today’s Date
_____________________________________________________________________________
Last Name (Please Print Legibly)
First Name
Middle Initial
______________________________________________________________________________
IU South Bend Student Identification Number
P a g e | 4