2019 candidate application - usac

ElectionBoard2019519KerckhoffHallLosAngeles,CA90024 2019FallElection

Email:[email protected]

2019 Candidate Application & Petition for Candidacy Form

1. My participation in the forthcoming election will be undertaken in

accordance with and will be governed by: a. All applicable policies and University regulations. b. The Undergraduate Students Association Constitution and its By-

laws.

Applicant’s Name:

Student ID: Email:

Phone Number:

Please read the following instructions carefully: This application must be completed in its entirety. All attestations in section 3 must be made in either the affirmative (yes) or the negative (no). This application must be signed and filed along with the Petition for Candidacy with the Undergraduate Election Board by the deadline stated below.

Filing Deadline: For Fall 2019 Elections, the Candidate Application & Petition for Candidacy form is due 5pm on Friday, October 4 th via email at [email protected]

Note: We will NOT be accepting any late applications. 5:01pm is considered late.

Application for Candidacy

I, __________________________________________________, (Full name, as it appears on University records), as evidenced by my signature, declare my intention to seek the office of _______________________________________ on the Undergraduate Students Association Council. My signature also affirms that I understand and agree to the following:

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Kyana Shajari

Kyana Shajari

Kyana Shajari


Email: [email protected]

c. The Undergraduate Students Association Code as interpreted and implemented by the Election Board Chairperson

I acknowledge that I may be disqualified from the election process upon severe infraction of the Election Code at the discretion of the Election Board.

2. I understand that I have the responsibility to be informed of my student status (as reflected on official University records) relative to all eligible criteria stated in the Election code pertaining to the specific office to which I am seeking candidacy.

3. I authorize the Office of the Dean of Students to confirm to the University appointed Advisor to the Election Board, the members of the Election Board, and the members of the Undergraduate Students Association Council whether each of my affirmative self-disclosed attestations provided within this application for candidacy is substantiated by or comports with University records.

4. I make this authorization freely and with the knowledge that the attestations and confirmations may be made available for the public copying and inspection (including campus media) about my eligibility for candidacy and I hereby waive whatever rights I may have to the confidential nature of the information provided by me or the Office of the Dean of Students.

5. I am responsible for showing support for my candidacy at the time I file this petition (as can be demonstrated by obtaining on the attached Petition for Candidacy) with the complete names (as they appear on University records) of UCLA registered and enrolled undergraduate students. I understand that the validity of the entries and information contained with the petition will be verified by the Office of the Dean of Students, according to standards determined by the Election Board Chairperson. I further understand that should the Chairperson find these entries not valid,

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I may not be recommended to the Undergraduate Students Association Council for certification as a candidate in the forthcoming election.

6. I understand that I will be required to attend the mandatory Campaign Orientation Meeting. I understand that if I fail to attend this meeting and sign the attendance roster, I will not be certified as a candidate in the forthcoming election.

7. I understand that I am responsible for all information contained within the Campaign Packet.

8. I agree that if I wish to resign from the position for which I seek election, I shall do so in writing and include therein my reasons for such resignation. I understand that such a letter of resignation may be published unless otherwise indicated upon my request, and the President of the Undergraduate Student Association Council may refuse publication for personal reasons for the discharge in writing.

If I am certified as a candidate, I wish to be identified on the ballot (in accordance with the Election Code) as follows:

Name to be printed on ballot:

I have read the preceding information and have made the required disclosures accurately and to the best of my knowledge.

Applicant’s name:

Applicant’s signature:

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Eligibility Requirement

Criterion

Applicant Attestation (Yes/No)

Office of the�Dean of Students Response (Yes/No/Indeterminable)

A. I am currently registered as

an undergraduate student at UCLA.

B. I am currently enrolled in at least four (4) quarter units.

C. I have at least a 2.00 (“C”) cumulative grade point average at UCLA.

D. I am not subject to any disciplinary sanctions, or terms of which would preclude my participation in University activities.

E. I am seeking the office of President and have completed (passed with at least a “D-”or “P,”according to University standards) ninety-six (96) quarter units,

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twenty-four (24) of which have been in-residence at UCLA.

F. I am seeking the office of

Internal Vice-President and have completed (passed with at least a “D-”or “P,”according to University standards) seventy-two (72) quarter units, twelve (12) of which have been in-residence at UCLA.

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My responses about my eligibility are truthful. I understand that if any of the above information is found to be dishonest, I will be subject to disqualification as determined by the Election Board and Dean of Students.

Applicant’s Name:

Applicant’s signature:

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Petition for Candidacy

I am seeking election to the office of _____________________________________________________ on the Undergraduate Students Association Council. By providing the information requested below, you can assist me in satisfying one of the requirements in the Undergraduate Students Association Election Code for the certification of my candidacy in the forthcoming undergraduate elections. Thank you.

Important Note: You must be a currently registered and enrolled undergraduate student for your signature on this petition to be valid. Please do not sign if you do not meet this requirement.

# Full Name UCLA Student ID Number

Signature

1.

2.

3.

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6.

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8.

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Kyana Shajari

Kyana Shajari



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ElectionBoard2019519KerckhoffHallLosAngeles,CA90024 2019 FallElection


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Candidates: The Election Code requires that this petition contain at least 200 signatures of registered UCLA undergraduate students accompanied by their correct Student ID number to be considered valid.

Name:

Signature:

Title: Date:

Wintercheck-inNameofapplicant:Date&timereceived:Receivedby:

Finalcheck-inNameofapplicant:Date&timereceived:Receivedby:

FOR THE OFFICE OF THE DEAN OF STUDENTS ONLY:

I have reviewed the University Student Records regarding the above affirmative candidate disclosures. The responses noted reflect the information available to me as of:

Summitedby:

FOR ELECTION BOARD USE ONLY

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2019 candidate application - usac

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