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Date:
Official Name of Organization
Name of Individual Submitting Form
Position in Organization
Organization Information
Month of Elections
Meeting Schedule (Please indicate how often your organization has meetings; ex: weekly, bi-weekly, monthly, once per semester, other.)
Member Fees (Please indicate how often your organization collects dues; ex: monthly, once per semester, annually, do not collect dues)
Amount of Fees Collected
Officer Information
President Name
President E-mail Address
President Phone Number
Vice President Name
Vice President E-mail
Vice President Phone Number
Treasurer Name
Treasurer E-mail Address
Treasurer Phone Number
Advisor Name
Advisor E-mail Address
Advisor Department
Advisor Box Number
Advisor Campus Phone Number
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