Student Senate Application for Fall Election 2016

(Please use this form as the cover sheet for your completed application)

Due: Friday, September 2nd by 12 pm in Massman 1 (Student Development)

Name: ______

Campus Address/Current Address: ______

______

Cell Number: ______Rockhurst Email:

Year in School: Freshman ___ Sophomore ___ Junior ___

I want my candidacy to be considered by: Ballot ____ Appointment: ____ Both: ___

Student Signatures: By signing below, I indicate my support for this candidate for the Rockhurst University Student Senate. I believe that they will serve the student body in a fair and unbiased manner, and will positively represent the interests of Rockhurst University students.

Note: 25 Student Signatures MUST be obtained.

Faculty/Staff Signatures: By signing below, I indicate my support for this student’s candidacy for Student Senate. Based upon my knowledge of this student, I believe they will represent Rockhurst University and Student Senate in a fair and unbiased manner.

XXXXXXX

Note. Five signatures from faculty/staff/administration MUST be obtained.

Questions: Please respond to the questions below. Each answer should be no more than 100 words in length. Please attach answers on a separate sheet.

1. Why do you want to be a Senator?

2. What improvements would you make to Rockhurst if you were given the power to do so?

3. What experiences from your past have prepared you for a leadership role as a Rockhurst University Senator?

4. Name one person of great influence and explain how that person has shaped your personal character.

5. How do you see the Jesuit Core values carried out in Student Senate, or how could you implement them in Student Senate if you were chosen to serve?

By signing below, I confirm that all information that I have submitted is honest and truthful. I understand that any falsification of material, signatures, or information will result in forfeiture of my candidacy. I also understand that any violation of election policies, procedures and guidelines may result in the same penalty. I authorize designated Rockhurst University personnel to view my academic and disciplinary records for purposes of eligibility confirmation, and permit them to convey my eligibility status (eligible or not eligible) to the Student Senate President (or designee for purposes of the election/appointment process).

Signed: ______Date: ______

In the FERPA form attached, please select Academic Transcript as well as Student Conduct Records to be considered for Student Senate.