JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Application to be an Appointed Student-at-Large
For additional questions or assistance, please contact Ashley Joseph, ASI Associate Director for Student Government at
aljoseph@cpp.edu
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Date of Application
*
MM
/
DD
/
YYYY
Name (First, Middle, Last)
*
Your answer
Bronco ID #
*
Your answer
Date of Cal Poly Pomona Entrance
*
To be eligible, you must have at least one semester completed at Cal Poly Pomona.
MM
/
DD
/
YYYY
CSU Pomona Email Address *any other emails will void application*
*
Your answer
Total Units Completed
*
Your answer
Number of Units Enrolled In
*
To be eligible, you must be currently enrolled in at least 6 semester units.
Your answer
Committee(s) Applying For:
*
University Wide Committees
ASI Elections Committee
ASI Facilities & Operations Committee
ASI Governmental Affairs Committee
ASI Basic Needs Committee
Required
Primary Phone Number
*
Your answer
Current Major
*
Your answer
Expected Graduation Date
*
Your answer
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
