Office of Student Engagement-Leadership
Organization Membership Information Form
__________Semester Date______20
Name of Organization: ____________________________ Chapter: __________________________
President Signature: ________________________________ Adviser Signature: __________________
(LIST ALL CURRENT MEMBERS INCLUDING OFFICERS! Show name and G # only (only Gray columns); leave all other
columns blank)
NAME
G
NUMBER
PREVIOUS
SEMESTER
GPA
CUMULATIVE
GPA
HOURS
REGISTERED
THIS
SEMESTER
HAZING
TRAINING
COMPLETE
Authorization: ________________________________ Verification: _________________________________
Student Organization Coordinator Registrar
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