Mississippi University for Women

Student Government Association

Statement of Candidacy

Please fill out and return via e-mail to Cochran 406 by Friday, September 10, 2010 at 12 p.m. All candidates must file this statement with their Statement of Intent and approve the authorizations and consents below to qualify as a candidate for office. *Please note that if elected, all Senators will be required to attend an SGA Retreat Tentatively Scheduled for September 24-25*

Full Given Name

Student ID #

Local Address

Permanent Address

E-mail address

Cell Phone #

Office Sought

Do you have class on Monday night?

Classification

Total Hours Earned at MUW

Total Hours Transferred

Semesters in Attendance at MUW (including current)

# of Currently Enrolled Hours

MUW GPA

Overall GPA

Department

Major

Organizations

I have read and understand the Student Government Association (SGA) Constitution provisions relative to the office I seek. I have also read, understand and agree to comply with the campaign rules as set forth in the SGA Constitution and pledge Zero Tolerance for criminal mischief, threatening communications, and / or falsifying evidence in regards to campaign or election violations. I hereby authorize the Elections Board to verify my grades, academic record, enrollment status, and disciplinary record and to release my grades, academic record, and enrollment status for voter information. If elected to the office I seek, I further authorize this same verification at the beginning of each semester. I hereby authorize the Elections Board to release my phone number and email address to groups or parties wishing to endorse candidates. I hereby give my consent to and authorize the Elections Board, Executive Board, and the Mississippi University for Women, including its Office of Public Affairs, to disclose to the media and the general public, with permission to re-disclose all records of any type maintained by the University and containing any personally identifiable information about me concerning or related to my candidacy for SGA office including, without limitation, election information, violation of campaign and other SGA election rules and/or provisions of the University’s Code of Student Conduct, hearing results, and sanctions imposed.

I Agree To The Terms And Conditions Above.

STATEMENT OF INTENT Please include a brief statement regarding your intent in running for the office you are seeking. It might also be called a platform statement, your motivation in seeking office, how could you benefit SGA by serving in this position, youf goals for SGA, etc. The Statement of Intent should be at least 50 words but please limit the length of your statement to no more than 300 words.