Title |
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Registration Type |
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Semester |
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Date Received |
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Club Name |
To update club information choose club name from the drop down list |
Meeting |
Club's Meeting Day/Time & Location |
Club Website |
Type the Web address: (Click here to test)
Type the description:
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Club Email |
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Elections |
Date when elections were held. Please remember to attach minutes. |
Officers Elected? | In order to charter a student club and maintain recognition at Kingsborough Community College, your group must elect from its membership the following officer positions: President, Vice-President, Treasurer, and Secretary. An officer must have a 2.0 minimum GPA and the President may not serve as an officer of student government. Club must also obtain a faculty or full-time staff member to serve as club advisor. Minutes showing the election results must be turned in with this form.
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| President |
First Name |
President's First Name |
Last Name |
President's last name |
SS# |
President-last 4 digits of ss# |
Street Address |
President's address-street |
City |
President's address-City |
State |
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Zip |
President's address-zip |
Ph# |
Preferred Phone Number |
Email |
Email |
Info Authorization | I authorize the Office of Student Life to share my contact information and my email with other club presidents and KCC students interested in joining my club.
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| Vice-President |
First Name |
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Last Name |
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SS# |
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Street Address |
Vice President's address-street |
City |
Vice president's address-city |
State |
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Zip |
Vice president-zip |
Ph# |
Vice president-preferred phone #
xxx-xxx-xxxx |
Email |
Vice president's email |
| Treasurer |
First Name |
treasurer's first name |
Last Name |
treasurer's last name |
SS# |
Last 4 digits of SS |
Street Address |
treasurer's address-street |
City |
treasurer's address-city |
State |
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Zip |
treasurer's address-zip |
Ph# |
treasurer's preferred phone # |
Email |
treasurer's email address |
| Secretary |
First Name |
secretary's first name |
Last Name |
secretary's last name |
SS# |
Last 4 digits of SS |
Street Address |
secretary's address-street |
City |
secretary's address-city |
State |
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Zip |
secretary's address-zip |
Ph# |
secretary's preferred phone # |
Email |
secretary's email |
| Advisor |
First Name |
Faculty/Staff Advisor- |
Last Name |
Faculty/Staff Advisor-last name |
Department |
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Mail Code |
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Room# |
Faculty/Staff Advisor-Room # |
KCC Ph. Ext. |
Faculty/Staff Advisor-Campus phone |
Email |
Faculty/Staff Advisor-KCC email address |
Previous Service | Have you served as advisor to this club in the past? |
How Long |
If so, for how many years? |
Guidelines | I have received the faculty advisor guidelines, and I have agreed to be the club/organizations's advisor |
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Attachments
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