Starting a New Club Form

Full Name *

Email Address *

Phone Number *

Your Primary Role at CCC *

Student

Faculty

Staff

Club Information

Name of the New Club/Organization *

What is the main purpose or focus of the club/organization *

Please state a Mission Statement *

What goals or learning outcomes will be achieved by participating in this Club/Organization *

If any, please list the names of the student officers for this club/organization *

What events or activities will the Club/Organization be hosting during the academic year *

Who will be serving as the Club/Organizational Advisor for this group *

Approximately, how many members are interested in starting this club/organization *

Will the club/organization be using Lone Tree Room 111 -The Crater for their meetings *

Yes

No

What times will meeting occur *

What campus will the meetings take place *

Does the club/organization need a account for fundraising purposes *

Yes

No

What are the current needs to help make this group successful *

Website

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