黑料正能量

1. Election to Office in Student Organizations

Yes

No

2. Candidate for Miss 黑料正能量 Contest

Yes

No

3. Sports Organizations

Yes

No

4. Who鈥檚 Who

Yes

No

5. Honor Societies

Yes

No

6. Fraternity and Sorority Membership Intake

Yes

No

7. Academic Honor Roll

Yes

No

8. Committee on Student Affairs

Yes

No

9. University Committees

Yes

No

10. Financial Aid/Employment Applications

Yes

No

I HAVE READ THE ABOVE STATEMENT AND I AM WILLING TO WAIVE PRIVACY OF MY EDUCATIONAL RECORDS FOR THE PURPOSE(S) CHECKED “YES”.

Student Name

Student ID Number

Date

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