Group Certification Form
Office of Student Involvement
Certifying a Group at Clover Park Technical College is as easy as:
1. Entering your group and group leader information in this certification form
2. A group leader attending a 1-hour Group Orientation Training
3. Submit your certification form to the Office of Student Involvement to make it all official.
The Student Council will formally certify your group and funding at their next regularly
scheduled meeting; you will receive email confirmation upon approval.
START HERE! – CONTACT INFORMATION
Name of Group:
Primary Contact Name:
Position/Role within organization:
Email:
Please provide an email for your club that we can post on our website and in our directory of clubs.
Phone Number:
WHAT DO YOU WANT TO DO – PURPOSE STATEMENT
Please describe the purpose and intended activities of your organization. (100-word limit)
GROUP MEETING INFORMATION
Day:
Time:
Location:
Please indicate below if you give us permission to have your group meeting information listed in the
directory and posted on the CPTC Events Calendar by placing your initials in the space given.
[
] We agree
[
] Please do not list our group meeting information
ACKNOWLEDGEMENT & UNDERSTANDING
1.
2.
3.
4.
Our group has access to campus resources and limited funding (basic printing and supplies).
Can meet and host group activities on-campus between 8-5 PM, Monday-Friday.
Are not required to attend Club Council Meetings or have a club advisor.
We have read and understand the content of the Clubs & Organization Handbook and hereby
agree to all elements previously stated regarding the regulations.
5. Upon certification by the Student Council, groups shall be eligible for $250.
6. Groups are eligible to become a registered organization after one quarter.
ARE YOU STUDENTS? WE SERVE STUDENTS FIRST!— STUDENT INVOLVEMENT
Services and resources available through the Office of Student Involvement are funded through student fees. It
is important that students are actively involved in the planning, development and implementation of programs
sponsored by these fees. Please verify that four other CPTC students are involved with this group:
[ ] We verify that there are four (4) or more members in our group.
REQUIRED DOCUMENTS & ORIENTATION
[ ] Group Certification Form
[ ] Attend a Group Orientation Training - Contact the Office of Student Involvement in the
Student Center, Room 206 to schedule a date/ time.
Please submit the completed certification form to involvement@cptc.edu.
CERTIFICATION
By submitting this certification form electronically to involvement@cptc.edu. I certify that the information
provided in this packet is true, correct and complete to the best of my knowledge. I understand that
consideration of this certification form depends on the true and accurate representation of facts as stated or
implied on this certification form.
- - - - - - - - - - - - - - - - - FOR OFFICE USE ONLY - - - - - - - - - - - - - - Group Orientation Training?
Certification Form Complete?
Approval at Student Council Meeting
YES
YES
YES
NO
NO
No
Confirmed by:
Confirmed by:
Confirmed by:
Submit this packet to The Office of Student Involvement
Student Center, Building 23 - Room 206
involvement@cptc.edu or 253.589.5780
Date:
Date:
Date: