BOARD OF ELECTIONS
Intent to Run Form: Part A Return form to 5261A Talley by Monday, February 13th at 5:00 p.m. Instructions and Regulations: All instructions and regulations concerning this form must be followed, or the form shall be considered invalid and your candidacy will be voided. • • •
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All spaces must be filled out unless otherwise noted. The “Full Legal Name” space must contain your name as officially appearing on University records. In the “Ballot Name Format” section, include your name exactly as you wish it to appear on the ballot. This formatted name must include the surname from your full legal name as well as at least one other portion of your legal name or common derivatives thereof. No name format that would confuse the electorate as to the identity of the candidate will be accepted, and no information will be included beyond your name. All candidates must submit both Part A and Part B. A hard copy of both forms must be submitted for the filing to be complete. These forms (PART A: Intent to Run and Part B Records Waiver) are due Monday, February 13th at 5:00 pm to 5261A Talley. Candidates are responsible for ensuring the Board of Elections has properly received and processed the form. The Board makes all received and processed forms public. Individuals failing to alert the Board to errors within 24 hours following the final publication of filings on Tuesday, February 14th shall forfeit any claim to candidacy.
Full Legal Name: (Last)
Student ID Number:
(First)
(Middle)
Unity ID:
Position Sought: __________________________________________________ Current College:
Class:
Month/Year of Initial Enrollment at University: Local Address: , NC (City)
Email Address:
(Zip)
Phone:
Ballot Name Format: I attest the information on this form is complete and accurate to the best of my knowledge and is under my just authorization
Signature:
Date:
BOARD OF ELECTIONS
Records Waiver Form: Part B Return this completed form to 5261A Talley by Monday, February 13th at 5:00p.m. Background Explanation: The Student Body Statutes (SBS §7-1.11) mandate that all candidates for elective office be in good standing with the University at the time of candidacy, defined as follows: SBS §1-1.1 (d). Definitions and conventions Within these Statutes, the following definitions shall apply: …(d) “Student in Good Standing” shall be clear of any academic probation, past or present suspensions or academic integrity probation. Beginning in February 2007, University administrators adopted a new, additional “Regulation for Undergraduate Student Leadership” that imposes the following additional requirements: 1. All candidates must have a minimum 2.5 cumulative GPA; 2. All candidates must be enrolled in at least 12 hours of classes; and, 3. All candidates must be free of active disciplinary sanctions, subject to the Review of the Office of Student Conduct Students who do not meet the requirements of this new University policy may request “special dispensation” (an exception to the policy) by contacting the appropriate University administrator: Academic Exception Requests: please submit a signed request containing your name, telephone and email address, and answers to the following questions (no request may be made in person): 1. Describe in detail the circumstances surrounding your academic performance (please note that all elected student leaders must maintain a 2.5 cumulative or semester GPA). 2. Provide a description of what you learned about yourself as result of your academic performance and how you have used this knowledge since that time (i.e. do you have recovery strategy developed? New study habits? Change in major?) Please be detailed in your response. 3. Provide any other information you want considered in the review of your petition. Contact: Director of Student Involvement 4234 Talley Phone: (919) 513-3990
Student Conduct Exception Requests: please submit a signed request containing your name, telephone and email address, and answers to the following questions: 1. Describe in detail the situation that resulted in the disciplinary charges. 2. Provide a description of what you learned about yourself as a result of the incident(s) and how you have used this knowledge since that time. 3. Provide any other information you want considered in the review of your petition. Contact: Paul Cousins Clark Hall, Room 300 Phone: (919) 515-2963
BOARD OF ELECTIONS
Records Waiver Form: Part B continued About this Form / Scope and Use of Information: This waiver is for the express purpose of verifying initial eligibility for candidacy in the current election, and does not apply for any other use. Information provided on release by this form will be held in confidence by the Elections Commission and will not be publicly disclosed. Records Waiver & Form Certification: I, , candidate for election to an office in the Student Body elections, do hereby attest that I am a duly enrolled student of North Carolina State University. I authorize the University or its agents to review my records to determine if I am in “good standing,” as detailed on this form, and report such fact to the Chairman of the Student Body Commission on Elections. I further certify that all information contained within this form is complete and accurate to the best of my knowledge. I understand that I am personally responsible for complying with all elections regulations on penalty of forfeiture of my candidacy and/or office. Signature:
Date:
Student ID Number:
Unity ID:
Position Running for: For Office Use Only: Eligible Ineligible Advisor Signature:
Date:
