University Ecclesiastical Endorsement Form – Fill Out and Use This PDF

Ecclesiastical Endorsement

Student Name

Student Instructions

•Carefully study the University’s Code of Honor.

•Schedule an appointment with your LDS bishop to complete the Student Pledge and Ecclesiastical Endorsement. Students of other faiths may also meet with an LDS bishop or a member of their own clergy.

Instructions for Ecclesiastical Leader

(bishop, branch president, mission president, member of stake presidency or other clergy)

•Please review the included Code of Honor with the applicant and interview the candidate to ascertain his/her ability and willingness to live the university’s standards.

•Indicate your endorsement or non-endorsement of the student and sign at the bottom of this page.

•Have the student sign the Student Pledge on the second page of this document, certifying that he/she has read and understands the standards by which he/she will be expected to abide while at Southern Virginia University.

•Mail, fax or scan and email the signed copy of this document to the university (see addresses below).

If there are other personal observations or unique circumstances about this applicant that would help the Admissions Committee in making its decision, please attach an additional statement when submitting this form.

1.I have known this student for ____________ years and/or _________________ months.

2.he candidate attends worship services ¨ every week ¨ twice-per-month ¨ infrequently

3. he applicant has honorably completed an LDS mission (typically 18 or 24 months)

¨ Yes ¨ No

a.If yes, where did the applicant serve? ________________________________________________________

4.	I have reviewed the Standards of Conduct with the applicant, and the applicant is now living and is committed to	¨ Yes	¨ No
	continuing to abide by these standards.
5.	I have reviewed the Dress & Grooming Standards with the applicant, and the applicant is now living and is committed	¨ Yes	¨ No
	to continuing to abide by these standards.
6.	Does the applicant demonstrate suicient respect and maturity to succeed and to live in harmony with others?	¨ Yes	¨ No
7.	Is the candidate on probation or parole, or has he/she ever been convicted of any crime other than a traic violation?	¨ Yes	¨ No
8.	Does the applicant live a chaste, virtuous and morally clean life, including avoidance of pornography, vulgarity, and	¨ Yes	¨ No
	sexual relations outside of marriage?
9.	Does the applicant abstain from and agree to continue to abstain from alcohol, tobacco, cofee, tea, and drug abuse?	¨ Yes	¨ No
10.	Do you feel the student is committed to and will live the Code of Honor on and of campus?	¨ Yes	¨ No

11.Do you endorse the candidate to attend Southern Virginia University? If no, please inform the applicant of your non- recommendation.

¨ I endorse ¨ I endorse with reservations ¨ I do not endorse this candidate

Please mail, scan and email, or fax both pages to

Southern Virginia University, Oice of Admissions, One University Hill Drive, Buena Vista, VA 24416

Fax: 540-266-3806 Email: admissions@svu.edu

Questions? Call the Oice of Admissions at 540-261-8401

Student Pledge

Code of Honor (Abbreviated)

Full text is available at svu.edu/honor.

Standards of Conduct

We, as students of Southern Virginia University, live honest, chaste, and virtuous lives; abide by the law; and show respect for self and others in all we do. We internalize our core values of scholarship, discipleship, accountability, enthusiasm, and reinement in the quest to become leader-servants. We are committed to living the principles of the Code of Honor in all our conduct.

•	Be honest	•	Respect others
• Obey the law and all campus policies		• Observe Dress and Grooming Standards
• Live a chaste, virtuous and morally clean life		•	Use clean language
•	Abstain from alcohol, tobacco, cofee, tea, and drug use	• Observe Residential Living Policies

Dress and Grooming Standards

Clothing should be modest and appropriate for the occasion. Men and women are to be clean and well-groomed. hey are to avoid extremes in clothing, appearance, and hairstyle. Men are to be clean-shaven, although trimmed moustaches are permissible. Students are not to acquire tattoos or body piercings. Preexisting tattoos should be covered as much as is practical. If women have their ears pierced, they should wear only one pair of earrings. Men do not wear earrings.

Student Pledge

I, ________________________________________________________________, declare that I have read, understand, and agree to

abide by the Southern Virginia University Code of Honor. With my signature, I authorize my ecclesiastical leader to release information concerning my personal conduct, including information on the Ecclesiastical Endorsement form.

LDS applicants: please provide the following contact information, which may be used in emergencies or to provide updates.

Bishop/Branch President	Ward/Branch
Home Address	City	State	Zip
Phone Number	Email (if available)
Stake President	Stake
Home Address	City	State	Zip
Phone Number	Email (if available)

Please mail, scan and email, or fax both pages to

Southern Virginia University, Oice of Admissions, One University Hill Drive, Buena Vista, VA 24416

Fax: 540-266-3806 Email: admissions@svu.edu

Questions? Call the Oice of Admissions at 540-261-8401