Club Registration Form

Club Registration Form
STUDENT ACTIVITIES OFFICE

A club's registration form must be submitted to the Student Activities Office with an updated list of club officers each year no later than the end of September. Those organizations that elect/select new leaders at the end of the Fall semester must complete a new form and submit it no later than the end of January of each year. Organizations submitting late forms will have their accounts frozen for a period of 30 days from the date of receipt of the form.

Please note that all fields, unless otherwise indicated, are required.

Name of Organization:
Name of Person Completing Form:
Position in Organization:

Please list the officers in your organization in the spaces below:

	Name	Year	Position	Phone Number
1.
2.
3.
4.

Officers are selected/elected each: Fall Spring

ADVISOR INFORMATION		SECONDARY ADVISOR INFORMATION
Primary advisor information is required. Complete the secondary advisor information only if applicable.
Name of Advisor:		Name of Second Advisor:
Select One:	Faculty Staff	Select One:	Faculty Staff
Department/Office:		Department/Office:
Campus Extension:		Campus Extension:

By electronically submitting this form, the club president certifies the following:

This organization will comply with all University policies and regulations of Stevenson University.
All club officers have a GPA of 2.0 or above and must maintain a 2.0 during their term.
All club officers are currently enrolled in at least 12 credits at Stevenson University.
All club officers are jointly responsible for club activities and will be liable for debts and obligations to the University and its auxiliary units incurred by the organization. This includes use of campus facilities.
Only the individuals listed on this form may reserve facilities in the name of this organization.