Petition for Formation of a Club or Organization
Your Name:
Your Email:
Official Club Name:
Contact Person:
Contact Student ID:
Contact Student E-mail:
Contact Student Phone:
Club Classification:
Select one...
Honor Society
Program/Subject Area Organization
Social/Service/Leadership Organization
Clubs with International Focus
Religious/Spiritual Organizations
Purpose:
Affiliated Organizations
Membership requirements (Park University requires a majority of members be enrolled students. Any voting member of the organization must be a Park University student):
Proposed Meeting Date and Time:
List of Officer Positions (President, Vice-President, etc., not specific student's names) and the Duties of Each (To be eligible to hold an office, a student must be enrolled in at least six (6) credit hours, with a minimum cumulative GPA of 2.00.
Position:
Position:
Position:
Position:
Position:
Position:
Election Procedures:
Club Fees or Dues (It is recommended that dues not exceed $5.00 to $15.00 per year. Exceptions are given to honor societies and organizations with national affiliations):
Club Membership (Minimum of five (5) Student Names. Please include e-mail and Park ID #):
Name:
Name:
Name:
Name:
Name:
Name:
Name:
Name:
Name:
Name:
Names of Faculty/Staff/Administrator Advisor and Alternate Advisor (Before signing, advisors should be aware of their responsibilities as outlined in the Student Club Manual section titled, "Advisor's Responsibilities". Advisors should also know that their involvement with an organization is not generally associated with an employee's normal work responsibility):
Advisor's Name:
Advisor's Name:
