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Student Representative Application Form

Step 1: Provide Application Information (*Required)
Title*
First Name*
Last Name*
Middle Initial
Suffix
Address 1*
Address 2
City*
State*
Zip Code*
Home Phone*
Work Phone
Cell Phone
Date of Birth
E-mail Address*
Confirm
E-mail Address*
Law School*
Date of Anticipated Graduation*
Current GPA*
Day or Evening Student*



Planned Course Location*
Step 2: Please Answer the Following Questions

Please list your law school activities, such as organizations, offices held, awards, etc. or anything else you would like us to consider:

I would like to be a Student Representative because:

Step 3: Submit Form


 
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