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PRESIDENT AND VICE PRESIDENTIAL TICKET REGISTRATION FORM

ELECTION 2013

PLEASE ATTACH COMPLETED PETITIONS, SIGNED COPY OF ELECTION RULES, and OFFICIAL TRANSCRIPTS TO THIS
FORM AND SUBMIT TO THE ELECTIONS COMMITTEE, STEWART CENTER G06, BY 5:00PM ON MARCH 4, 2013

Student Body Presidential Candidate


NAME: __________________________________________________
PHONE: ( ___________) _____________________________________
E-MAIL: ____________________________________________ @ purdue.edu
LOCAL ADDRESS: __________________________________________________
__________________________________________________
COLLEGE:

__________________________________________________

CLASSIFICATION: __________________________________________________
MAJOR(S):

__________________________________________________

CUMULATIVE GPA: _______ / 4.00

Student Body Vice Presidential Candidate


NAME: __________________________________________________
PHONE: ( ___________) _____________________________________
E-MAIL: ____________________________________________ @ purdue.edu
LOCAL ADDRESS: __________________________________________________
__________________________________________________
COLLEGE:

__________________________________________________

CLASSIFICATION: __________________________________________________
MAJOR(S):

__________________________________________________

CUMULATIVE GPA: _______ / 4.00

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