ASCC
Club/Organization Official Name:
Name
Cell #
CC ID#
President
VP
Secretary
Treasurer
ICC Rep
Advisor Information
Name
Email
EXT
Secondary Advisor:
Name
Email
EXT
*Additional Advisor Name:
Email
EXT
Name
CC ID #
Email Address
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Club/Organization Meeting Information:
Building & Room Requesting
Dates
Time
# of Attendees
Check the box that pertains to your club:
New
Continuing
Club Roster
Spring 2016
Fall Semester Spring Semester
*Additional Advisors will ONLY be copied on information. (No Signature Authority)
****IMPORTANT CLUB PARTICIPANTS MUST HAVE: ****
2.0 GPA /Enrolled in 1 unit or more 5 units to be an Officer/Current CCID Sticker
Revised 1/2016
Check the box for the semester your roster is for:
*All Organizations/Clubs MUST have at least 10 members.
**FORM MUST BE TURNED INTO STUDENT ACTIVITIES BY 12PM ON FEBRUARY 11, 2016**