Campus Club Registration –

Territory *

Campus Club Official Name *

Official Campus Club Status *Is the campus club officially registered with the student government?

Yes, we are officially registered

We are working on registering

Other

How long has your Campus Club existed? *

How often does the campus club hod meetings? *

Once a week
Once a month
Twice a month
Other

Supporting line organizaition name
Ex: West Side Chapter

Officer 1

Officer's Name *

Officer's Position *

Division (choose one) *

Young Men's Division (YMD)

Young Women's Division (YWD)

Leadership Position

Phone Number *

Email *

Add another facilitator

* Required fields