Varennes Academy of Communications & Technology
Student Government Application for Class Representatives
2015 – 2016
Candidates and Parents/Guardians,
We are so glad that you are interested in becoming a part of this year’s Student Government! The
student government will share students’ views on issues involving our school, participate in community
service activities, provide student leadership and role modeling, and represent the student population at
our school. The guidelines are given below. Please read through them and follow them carefully.
Candidates not following guidelines are subject to disqualification. Please feel free to contact me if you
have any questions/concerns. Thank you!
Dr. Mitchell
School Counselor
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Student Name _________________________________ Due Date: Friday, Sept. 18th, 2015
Homeroom Teacher _____________________________ Grade: ◊Third ◊Fourth ◊Fifth
----------------------------------------------------------------------------------------------------------Requirements for Student Council Positions:
 Students must embody the following characteristics:
o Be a good citizen – follow all school rules.
o Be a hardworking responsible student.
o Get along well with other students and adults.
o Be excited about helping our school and community.
o Be able to attend the meetings (once a month at 7:45am)
 Teacher signature verifying the above requirements (endorsement for candidacy) required.
 Parent/Guardian signature verifying the above requirements (endorsement for candidacy) required.
 Completed application turned in by Friday, Sept. 18th, 2015
 If you choose, you may display a poster. Each candidate may make no more than two posters and must
be no larger than 12 x 18 inches.
o All posters must be approved by Administration (Mrs. Bufford/Mr. Williams) or the School Counselor
(Dr. Mitchell) by Monday, Sept. 21st, 2015.
o All candidates must remove posters by Friday, Sept. 25th, 2015.
 Distribution of tags, buttons, candy, gum, T-shirts, etc. shall not be allowed. Bribing will result in
disqualification.
----------------------------------------------------------------------------------------------------------Student Council Position Applying For:
Third Grade Position
Fourth Grade Positions
Fifth Grade Positions
◊Class Representative
◊ Class Representative
◊ Class Representative
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Endorsement for Candidacy:
I hereby officially endorse the candidacy of ___________________________________ (Student Name) for
Student Government. I support this candidate’s nomination and declare that s/he is of good character. The
candidate embodies the V-ACT characteristics. I understand that this form must be received by Friday,
September 18th, and that no late entries will be accepted.
Parent Signature
Date
Teacher Signature
Date
----------------------------------------------------------------------------------------------------------Student Acknowledgement of Election Responsibilities:
I ____________________________ (student signature) understand that I am taking part in elections to
represent my class and school as a leader and a role model for other students. If my behavior is not
appropriate at the time of the elections or after I have been elected as class representative, I understand
that I will be removed from my position. I commit to be at the meetings that will be held once a month at
7:45am.
----------------------------------------------------------------------------------------------------------Essay/Speech Requirements: (THIS IS OPTIONAL FOR CLASS REPRESENTATIVES)
Please write your essay/speech by answering the following questions in 3 – 5 sentences. At
your teacher’s discretion, this may be read aloud to classmates. (attach an additional
page, if necessary)
1. What does being a leader mean to YOU?
2. What makes YOU a strong leader?
3. Why YOU would be a good class representative?
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