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Club Registration Form

Name of Club/Organization
   
Purpose of Club (please provide a short description which may be included in publications -- only necessary if you wish to change your description or if this is a new club)
   
Name of Contact Person
           
CMR Phone E-mail
     
Would you like your contact information available on the web? Yes No
Include phone number? Yes No
Include e-mail address? Yes No
     
Does your club have an e-mail address? Yes No  
If yes, please give address
Does your club have a web page? Yes No  
If yes, please give address
Is club a sport/recreation club? Yes No  
Name of Faculty/Staff Advisor
   
MEMBER NAME
CMR
PHONE
CLASS YEAR
TITLE (i.e. Pres., VP, etc.)
President
Vice President
Secretary
Treasurer