Grade Authorization Form

Grade Authorization Form

Thank you for serving as an ASI representative on committees. Should you wish to continue to serve next semester, please complete the form below.Associated Students, Inc. aligns with the University's minimum grade point average of 2.0 per semester to hold committee positions. The GPA may be checked at the time of appointment and/or at the end of each semester.
Name*

First NameLast Name
Preferred Pronouns *
Student ID Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Are you an undergraduate student or a graduate student?*

UndergraduateGraduate
Committees(s)*
Would you like to continue serving on your committee(s)?*

YesNoCannot serve because I am graduating or leaving Sacramento State
I understand that I must maintain a grade point average (GPA) of at least 2.0 as long as I serve as a representative on a committee for Associated Students, Inc. I authorize the University to use my academic information for the sole purpose of determining eligibility to hold membership with committees.
Print Name (Full)*
Date*
Should be Empty: