College of Engineering Committee: Student Representative Application for 2020-21

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1. Personal Information:

Name:

Email Address:

Phone Number:

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2. Student ID Number:

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3. Semester Admitted:

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4. Grade Level (Fall 2020)

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5. Major:

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6. G.P.A:

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7. I am applying for appointment on the following committee:

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8. Why do you wish to serve on this committee?

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9. By initialing below, I am indicating that the statements above are factual to the best of my knowledge and that I agree to fulfill the responsibilities of the committee, including having my name published and holding office hours (at least 1 hour every two weeks).

Thank you for applying.