Student Relations Committee Application Spring 2018

We are excited that you would like to apply to be on one the College's Committees. Please let us know more about you and why you would like to serve on a committee.

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1. Personal Information:

First Name:

Last Name:

Preferred First Name:

Email Address:

Phone Number:

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2. Gender Identity:

Female

Male

Transgender

Decline to State

Other (please specify)

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3. Race/Ethnicity (please select all that apply):

Asian/ Pacific Islander

African American

White

Native American/ American Indian

Latino/a / Chicano/a

Middle Eastern / North African

Mixed

Decline to State

Other (please specify)

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4. Grade Level

2nd

3rd

4th

5th

Graduate

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5. Did you start at Cal as a:

Freshman

Transfer

Graduate Student

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6. Expected graduation date (include "Spring" or "Fall" and year):

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7. Major:

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8. Why do you wish to serve on this committee(s)? (maximum 500 words)

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9. If you are selected to be a committee representative, how will you obtain input from the students you are representing? (maximum 500 words)

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10. I certify that I am in good academic standing with the College of Engineering and with the University of California, Berkeley.

Yes

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11. I certify that I have not been found responsible, or am not currently being investigated for an alleged violation(s), to the student code of conduct.

Yes

Thank you for applying. Please allow 6-8 weeks after the applications have been closed for us to notify you with committee decisions.