Student Activities & First-Year Programs

(*) denotes required information.
* Name of Organization:
* Organizational Email (or contact email) :
* Advisor's Name:
* Advisor's Department
* Advisor's Email:
* Advisor's Campus Box:
* Advisor's Phone:
Officer Information (Please include all leadership positions within the club or organization. If there are more positons than space provided, please submit information in the field labelled "More Information.")
*Chief Officer #1 Information First Name:
* Last Name:
* Title:
* Student ID:
*Chief Officer #2 Information First Name:
* Last Name:
* Title:
* Student ID:
Chief Officer #3 Information First Name:
Last Name:
Title:
Student ID:
Chief Officer #4 Information First Name:
Last Name:
Title:
Student ID:
More Information:

* Statement of Purpose:

* Check Appropriate Response:
I certify that our constitution and bylaws have NOT changed Our constitution and/or bylaws HAVE changed. (Please submit copy to the Clubs Liaison.)
* Electronic Signature
I certify that the above information is accurate and I acknowledge my responsibility to keep this record correct by informing the Office of Student Activities and First-Year Programs of any changes in information and/or in our constitution and by-laws. (Checking this button serves as your electronic signature.)

300 North Washington Street · Gettysburg, PA 17325
P: 717.337.6300