Starting a New Club Form

Starting a New Club Form
This form is an interest form to initiate a conversation about starting a club at Coconino Community College. If you have questions about this form and the questions we are asking or about what it means to be a Student Life Club, please reach out to Sarah.Heemstra@coconino.edu
Name*

First NameLast Name
Email*
example@example.com
Phone Number
Please enter a valid phone number.
Your Primary Role at CCC?*

StudentFacultyStaff
Club Information
Name of the New Club/Organization*
What is the main purpose or focus of the club/organization*
What goals or learning outcomes will be achieved by particpating in this Club/Organization?*
Please outline any additional information you have cultivated about the plans you have for the club (i.e. event ideas, meeting times, student interest/requests, etc.)*
Who will be serving as the Club/Organizational Advisor for this group?*
Approximately, how many members are interested in starting this club/organization?
Does the club/organization need a account for fundraising purposes?

YesNo
By signing below I agree to meet with the Student Life Coordinator to discuss the next steps for developing the club.
Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty:

Club Information