Student Clubs & Organizations | APPLICATION FORM
Application for official recognition as a student organization at Minot State University.
Name of Proposed Organization: ______________________________________________________
Nickname or Abbreviation: __________________________________ Date: _____ / _____/ _____
Briefly describe the purpose of the organization. In what way does the proposed club serve
to benefit this campus and the members of the organization:
Signature of at least ten currently enrolled Minot State University students as prospective
members for the above-mentioned club/organization supporting this petition.
1. ______________________________
6. ______________________________
2. ______________________________
7. ______________________________
3. ______________________________
8. ______________________________
4. ______________________________
9. ______________________________
5. ______________________________
10. ______________________________
* Continued on reverse side
CLUB CONTACT INFORMATION | Student Representative
Name: ____________________________________________ Phone: _________________________
Address: ___________________________________________________________________________
Email: ______________________________________________________________________________
Signature: _________________________________________ Date:___________________________
Faculty/Staff Advisor
Name: ____________________________________________ Phone: _________________________
Email: ______________________________________________________________________________
Signature: __________________________________________________________________________
When this form is signed by the organization representative, organization advisor,
and the Student Welfare and University Affairs Committee chairperson, the proposed
organization will be officially recognized by the University and granted use of the
University facilities for organizational meetings. A proposed constitution must be
submitted to the chairperson of the Student Welfare & University Affairs Committee
along with this form before any action may be taken by the organization.
_________________________________
Student Government Association
President
__________________________________
Student Welfare & University
Affairs Chairperson