Fillable KAPI`OLANI COMMUNITY COLLEGE Renewal Application (Kapiolani Community College)

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KAPI`OLANI COMMUNITY COLLEGE Renewal Application (Kapiolani Community College)

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KAPI`OLANI COMMUNITY COLLEGE
REGISTERED INDEPENDENT ORGANIZATIONS (RIO)
Renewal Application
This application should be filled out to renew your organization’s registration between academic years. The
first deadline for submittal is September 30
. However, if your organization does not meet this deadline,
registration is accepted throughout the academic year.
We advise registering early so new students looking to get involved have access to your organization’s most
current information, during summer orientation and at the beginning of the semester. Please contact the
Office of Student Activities (OSA) at 734-9576 if you need assistance with this application.
*Note: Use this application if your organization has been registered within the last academic year. Otherwise,
please fill out the “New Group Application for Registration”
Registration Checklist
o Completed Application
o Constitution/Charter of the Organization (If Constitution/Charter is not on file or has
been changed)
o RIO Orientation (If Contact person is different from the past Academic Year)
o Names and Signatures of the four (4) Designated RIO Representatives
o If applicable, affiliation with any local, national, or international organization if not
already on file with OSA, that Organization’s Constitution, Charter and/or By-Law
Please submit completed application to the Office of Student Activities (OSA) in `Iliahi 126 for approval.
KAPI`OLANI REGISTERED INDEPENDENT ORGANIZATION (RIO) RENEWAL APPLICATION
NAME OF ORGANIZATION: ___________________________________________________
Date submitted: _______________ Person Requesting Renewal: __________________________
Was the organization registered in the most recent academic year? Check one: Yes No
If yes, your organization may use this form to renew its registration.
If no, your organization may not use this form to register. Please fill out the Kapi`olani Registered Independent
Organization Application for Registration.
Has the organization’s constitution/charter changed* since your previous registration/renewal?
Check one: Yes No
If no, your organization may use this form to renew its registration.
If yes, your organization may not use this form to register. Please fill-out the Registered Independent
Organization Application for Registration.
*Changing your constitution/charter includes any changes to the organization’s name, purpose, membership,
organizational structure or operating procedures, which your organization has on record with the Office of Student
Activities (OSA).
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1. Main Contact Person: __________________________ *8-digit UH Number _____________
UH Email: _________________@hawaii.edu Position in the RIO: ______________________
Phone contact: _______________ Kapi`olani Affiliation: ____________________________________
Home Cellular Other: ______________
(Student, Faculty, Staff; For Faculty & Staff. Please include Dept.)
The designated contact person is required to attend a RIO Orientation session with the OSA Office. Has the contact
person listed above attended an RIO Orientation session?
Check one: Yes No If yes,
date: ______________. If no, please contact the OSA office to sign up for an orientation session.
The designated contact person is required to sign the “Agreement for a Registered Independent Organization” Form. Has
the contact person listed above previously signed the agreement on behalf of this organization?
If no, please sign and submit
the agreement with this renewal application. The agreement is available at the
http://osahome.kcc.hawaii.edu/
Check one: Yes No
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2. _____________________________________ *8-digit UH Number: _________________
UH Email
: _______________ @hawaii.edu Position in the RIO: _____________________
Phone contact: _____________
Kapi`olani Affiliation:__________________________________
Home Cellular Other: _____________________ (Student, Faculty, Staff; For Faculty & Staff. Please include Dept.)
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3. _____________________________________
*8-digit UH Number: _________________
UH Email
: _______________ @hawaii.edu Position in the RIO: _____________________
Phone contact: _____________
Kapi`olani Affiliation:__________________________________
Home Cellular Other: _____________________ (Student, Faculty, Staff; For Faculty & Staff. Please include Dept.)
≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈
4.
_____________________________________ *8-digit UH Number: _________________
UH Email
: _______________ @hawaii.edu Position in the RIO: _____________________
Phone contact: _____________
Kapi`olani Affiliation:__________________________________
Home Cellular Other: _____________________ (Student, Faculty, Staff; For Faculty & Staff. Please include Dept.)
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*To obtain your UH number go to the following URL: www.hawaii.edu/account. After logging in, you will be able to retrieve your 8-digit UH number.
Officers and/or designated representatives listed below have read and understand the Administrative
Policies and Terms of Agreement.
(Signatures of officers or designated representatives must be affixed in the same order as listed above)
NAME OF ORGANIZATION: ______________________________________________________
Main Contact Person; _____________________________ ___________________________________
Print Name Signature
(2) ____________________________________________ ___________________________________
Print Name Signature
(3) ___________________________________________ ____________________________________
Print Name Signature
(4) ___________________________________________ ____________________________________
Print Name Signature
For Office Use Only-
Category: ___ Academic/Professional ___ Ethnic/Cultural ___ Sports/Leisure
___ Honorary Society ___ Religious/Spiritual ___ Service
___ Political ___ Other (specify): ____________________________________
Attended RIO Orientation: __________(yes/no) Date: _____________________________
Submitted RIO Agreement: _________(yes/no) Date: _____________________________
IN WITNESS THEREOF, the parties have executed this Agreement below:
NAME OF RIO:_________________________________________________
BY_____________________________________________________________________
RIO Authorized Representative(s) NAME [Main Contact Person(s)]
BY_____________________________________________________________________
RIO Authorized Representative(s) SIGNATURE [Main Contact Person(s)]
TITLE:__________________________________________________________________
DATE:__________________________________________________________________
Office of Student Activities Representative Approval (For office use)
BY_____________________________________________________________________
University Authorized Officer’s Name (OSA Representative) (Print)
BY_____________________________________________________________________
University Authorized Officer’s Signature
DATE:_________________________________________________________________
Effective Date of Agreement
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Completed 7 September 2020

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