Your information First Name Last Name Permanent Address Follow format of: Street, City, State, Zip Local Address Follow format of: Street, City, State, Zip Phone Number Penn State Email Address PSU ID Number (example: 999999999) Major Semester Cumulative GPA Eligibility Are you a full-time student? Yes No What is your expected date of graduation? Have you received a disciplinary sanction at Penn State or any other higher education institution? Yes No Have you ever been convicted of a felony or misdemeanor crime? Yes No Please list all activities or employment that could result in a leave of absence from the board. (i.e. practicum, student teaching, internship) Essays Give two reasons why you are interested in becoming involved with the Student Disciplinary System. In your opinion, what is the role of the University Conduct Board? Must be shorter than 300 words. In your opinion, what should be the purpose of sanctions? Must be shorter than 300 words. As a peer educator, how would you approach talking to your fellow students about the Code of Conduct? Checking this box acts as your signature Submit