Executive Application
for the 2016-2017 Academic Year
Candidate Name:
Taylor Gordon
PLEASE RETURN TO THE STUDENT GOVERNMENT OFFICE, ROOM 052 IN THE
LOWER LEVEL OF THE DREYFUS UNIVERSITY CENTER.
GENERAL INFORMATION:
Name: Taylor Gordon
Student ID Number: 11304361
Student Email: tgord361@uwsp.edu
Local Address: 6023 HWY 54 Plover WI, 54467
Local Phone: 715-630-4842
Semesters Remaining at UWSP: 2
Grade Point Average 2.0 or above?
YES
NO
Enrolled for 6 or more undergraduate credits? YES
NO
Enrolled for 3 or more graduate credits?
NO
Major(s): Health Science
Minor(s): Psychology
POSITIONS AVAILABLE:
 Health Services Student Director
SPECIFY YOUR POSITION PREFERENCES:
1. Health Services Student Director
YES
WORK/INTERNSHIP EXPERIENCE (MOST RELEVANT):
Position Title: Health Services Student Director
Employment Dates: September 2015-May 2016
Employer: UWSP-SGA
Phone: (715) 346-4592
Direct Supervisor: Alan Bustamante
Primary Job Duties/Skills Learned:
o Chair the Student Health Advisory Committee
o Develop relationships with and meet regularly with leaders from all the
health and wellness related student organizations
o Develop a working relationship with the Director of Student Health
Services, Director of Counseling Services, and other health and wellness
professional staff.
o Actively promote a healthy lifestyle through the seven dimensions of
wellness
o Proactively address health and wellness concerns and policy issues
o Work with the Director of Student Health Services and the Student
Governance Association Budget Director in compiling the annual
allocable and non-allocable budget for Student Health Services
o Direct students to the proper outlets to obtain assistance with questions
related to health, counseling, wellness, prevention, and safety
o Work on all Alcohol and Other Drug (AODA) projects and policy
o Work on projects and programming to address student health and
wellness needs
o Attend, as often as possible, health and wellness student organization’s
events, meetings, and programs
o When delegated, serve as the Vice President’s appointee on University
health and wellness committees, task forces, and work groups
o Actively recruit students to get involved in the Student Health Advisory
Committee
o Serve as a voting member on the Segregated University Fee Allocation
Committee
o Attend the Student Governance Association Senate and the Executive
Staff meetings
REFERENCES:
(Campus or Stevens Point area references preferred)
Name: Anna Haug
Address: 5760 East River Rd APT 204 Fridley, MN 55432
Phone: 920-266-7380
Relationship: ¬Previous Student Health Services Director
Title: Customer Experience Professional
Name: Jen Sorenson
Office: 206 Delzell Hall, 910 Fremont Street
Phone: 715-346-4646
Relationship: Supervisor
Title: Administrative Director, Physician’s assistant
ADDITIONAL QUESTIONS:
I give my permission for my references and previous employers to be contacted:
YES
NO
I give my permission for my academic standing and GPA to be checked:
YES
NO
IN ORDER TO COMPLETE YOUR APPLICATION, PLEASE SUBMIT THE
FOLLOWING:
 This form, completed in its entirety
 A cover letter, either focused on your first preference or (if your interest is
tied equally between two positions) explaining both interests
 Typewritten responses to the questions on the following page
(preferably within this document)
PLEASE ANSWER THE FOLLOWING QUESTIONS THOROUGHLY AND
COMPLETELY.
1. Why are you interested in this position? What drew you to it?
2. What skills, traits, or experiences do you have which qualify you for your preferred
position(s)?
3. If you were hired for an executive position within SGA, what would your main focus
be? (You may have several.)
4. Describe your involvement on campus, past and present.
5. How does this position contribute to your professional goals or your future in general
I certify that all information on this application is accurate and complete to the
best of my knowledge. I understand that any misrepresentation or omission of
facts could render my application void or be sufficient grounds for my
termination.
Signature:
Date:
Email John Peralta at john.a.peralta@uwsp.edu with any additional comments,
questions, or concerns.