MOHAWK VALLEY COMMUNITY COLLEGE
STUDENT CLUB/ORGANIZATION REGISTRATION
Semester __________
Please print the following information.
CLUB/ORGANIZATION NAME ____________________________________________________________
OFFICERS AND MEMBERS (Must list at least 10 students, officers first. All signatures need to be hand printed by each individual).
If more space is desired, use the back of the sheet!
POSITION NAME (PRINT)
LAST 4 DIGITS OF
M NUMBER
E-MAIL
Statement of Compliance: Student organizations at MVCC may not restrict membership on the basis of race, color, sex, national origin, ancestry, age, disability,
marital status, sexual orientation, criminal record or veteran status. (Fraternities and Sororities are exempt from sex discrimination aspects of this law under Title IX
for the Educational Amendments of 1972.) We read this and understand that the constitution and by-laws of our organization must adhere to the above.
Prohibition of Hazing: “Any action which threatens the mental, psychological, or physical health of another person at the college including those actions for the sole
purpose of initiation into or affiliation with any organization (hazing)” is prohibited at MVCC (Student Code of Conduct). Hazing is considered to include but not be
limited to: interference with personal liberty of others; acts of domination by some students over others that may lead to injury, emotional disturbance, physical
discomfort or humiliation; harassment by banter, ridicule, criticism, or playing humiliating tricks or pranks; the forced consumption of alcohol, drugs or other
substances. We have read this and understand that our organization will not participate in any such activity.
MVCC is committed to a discrimination and violence free environment. For more information visit www.mvcc.edu/title-ix
STUDENT REPRESENTATIVE SIGNATURE: ______________________________________________
MEETING DAY ________________________________________ MEETING TIME _________________
MEETING LOCATION _____________________________________________
__________________________________________________
REGISTRATIONACCEPTED BY COLLEGE/DATE
