Community College of Rhode Island

Student Government Application

Please complete the following on-line application and click on Submit Form when finished.
Personal Information: (All Fields Required)
First Name:
Last Name:
Work Phone (xxx-xxx-xxxx):
Home Phone (xxx-xxx-xxxx):
Street Address:
Zip/Postal Code:
Academic Information: (All Fields Required)
Number of Credit Hours
Please Select Campus:
Knight Flanagan Liston Newport County
Full Time:
Yes No
Part Time:
Yes No
Are you a member of any clubs or organizations on campus?
  Yes No
Name of Clubs/Organizations:
Do you have any past experience in a leadership role?
  Yes No
If yes, please list:
Statement of Understanding:
  1. I cannot be considered for Student Government until I complete this application.
  2. I must be in excellent academic standings in order to participate in Student Government.
  3. I have been advised to revise my semester schedule in the event that I am selected to participate in Student Government.

I agree to this Statement of Understanding:  Yes: No: