Undergrad Student Programs Application - 2016 (Page 4 of 4) in pdf

Senate Standing

Appropriate Original Documents

Committees:

Suitable and Acceptable for

Employment Eligibility Verification of

Topical and Policy Areas

United States Citizenship are Required

n Aging

Under New York State Senate guidelines coordinating with

n Agriculture

U.S. Citizenship and Immigration Services standards, those

n Alcoholism & Drug Abuse

selected to be Session Assistants shall be required to con-

n Banks

firm their United States citizenship before enrollment (see

n Children and Families

n Cities

Title 8, United States Code, Sec. 1324A).

n Civil Service and Pensions

The following original documents qualify as independent

n Codes

or stand-alone forms of verification:

n Commerce, economic Development and Small Business

List A: n A United States Passport, n A Certificate of United

n Consumer Protection

n Corporations, Authorities and Commissions

States Citizenship, or n A Certificate of Naturalization.

n Crime Victims, Crime and Correction

Alternatively, inter-dependent forms of identification that

n Cultural Affairs, Tourism, Parks and Recreation

satisfy rules of verification may be assembled — that is,

n education

matched — one from each of the following two lists:

n elections

n energy and Telecommunications

List B: n A current New York State driver’s license or NYS

n environmental Conservation

DMV non-driver ID with photograph, or n A United States

n ethics

Military Card.

n Finance

n Health

List C: n An original Social Security Card — other than

n Higher education

a card stating it is not valid for identification or not valid for

n Housing, Construction and Community Development

employment — or n A Certificate of Birth issued by a state,

n Insurance

county, or municipal authority and bearing certification.

n Investigations and Government Operations

n Judiciary

If you have a special situation or set of circumstances discuss

n Labor

it with your CLO or the Office of Student Programs NOW. If

n Local Government

you are selected, you must be able to present the necessary

n Mental Health and Developmental Disabilities

and appropriate identification at the time of enrollment or

n Racing, Gaming and Wagering

you will not be allowed to join the program and you may be

n Social Services

separated from the program for cause at any time.

n Transportation

n Veterans, Homeland Security and Military Affairs

Faculty Certification of Endorsement and Coursework-in-Progress

n I am the on-campus Advisor-of-Record of the applicant and a member of the college faculty/administration with authority

to certify that the applicant was enrolled full-time throughout the immediately previous spring semester, is enrolled full-time during

the current fall semester, and has the endorsement of the faculty of this college/university to apply for and, if selected, to enroll

and earn on-campus credit for participation in the Undergraduate Session Assistants Program under the standards and rules of

this college, and Senate guidelines.

n I have reviewed the academic record and determined that the applicant is currently enrolled in and making satisfactory prog-

ress toward completion of each of the following courses:

Coursework-in-Progress

CODe/NO.

NAMe

CReDIT

1. ____________

_______________________________________________________________

____________________

2. ____________

_______________________________________________________________

____________________

3. ____________

_______________________________________________________________

____________________

4. ____________

_______________________________________________________________

____________________

5. ____________

_______________________________________________________________

____________________

6. ____________

_______________________________________________________________

____________________

n I certify that I have established that all the above is true and accurate and that the applicant has the endorsement of this

college as an able student suitable for mature off-campus experiential participation in the Senate program; and that I understand

academic planning, tracking, and evaluation of the applicant are the responsibilities of faculty and/or administration of this college.

_____________________________________________________

____________________________________________________________

Typed name of Authorized Campus Official

Signature: Authorized Official

Department: _____________________________________

Title: _________________________________________________

College: _________________________________________

Tel.: _________________________________________________

email: __________________________________________

FAX: _________________________________________________

PRI NTeD ON ReCYCLeD PAP eR

Undergrad Student Programs Application - 2016 Page 4

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