Student Senate Interest Form

Name *

Please enter your first and last name.

Home phone *

Please enter your home phone number in the following format: (608) 246-6576

Cell phone

Please enter your cell phone number in the following format: (608) 246-6576

Street Address *

Enter your street address (Example: 3550 Anderson St.)

City *

Zip Code *

Enter your 5-digit zip code

E-mail address *

Enter the e-mail address you would like us to use to contact you

Primary campus

Please list the campus where you attend most of your classes

Field of study

What program are you attending at Madison College?

Credits enrolled in

How many credits are you enrolled in this semester?

Student Senate roles

President

Vice President Administration & Finance

Vice President of Communication

Vice President of Learning

Vice President of State & Local Government

Senator

Please indicate if you are interested in a Senate officer position or a role as a Senate member.

Senate Committees

Please indicate which Senate committees you are interested in.

College Committees

Academic Appeals

Americans with Disabilities Act

Environmental Sustainability Alliance

Food Service

Student Activities Board

Please indicate which college committees interest you the most.

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