Class Representative Application

Name(Required)

First Last

Empl ID(Required)

Phone(Required)

Email(Required)

Major(Required)

Major Other

Cumulative GPA(Required)

References

Must be current LaGuardia Community College faculty or staff

Reference 1 Name(Required)

First Last

Reference 1 Phone(Required)

Reference 1 Email(Required)

Reference 2 Name(Required)

First Last

Reference 2 Phone(Required)

Reference 2 Email(Required)

Letter of Interest(Required)

Draft Speech(Required)

Written outline or URL to 45 second video clip

Acknowledgement(Required)

By entering my initials, I attest that the information provided is true and accurate. The ideas expressed in my draft speech are original. I understand that submitting false, inaccurate or unoriginal information may render my application null and void.

Name

This field is for validation purposes and should be left unchanged.