REQUEST TO ORGANIZE A NEW CLUB
Las Positas College Student Government (LPCSG)
Inter-Club Council (ICC)
Name of Proposed Club/Organization:
Purpose and Goals of Club/Organization:
We, the undersigned, agree to the following:
1. Club/organization membership will be open to all currently enrolled Las Positas College students regardless of race, religion, sex, orientation,
national origin or disability.
2. The club/organization must have a student representative attend ICC meetings in order to remain active and hold meetings, events and be
eligible to receive funding from ICC.
3. The club/organization will have as part of its purpose the philosophy of service to the students and to the community of Las Positas College.
4. The club/organization will work in cooperation with other clubs/organizations for the good of the entire Las Positas College community.
5. The club/organization will inform its members of school policies as they relate to clubs/organizations and will observe these policies in all
official activities of the club/organization.
6. The club/organization will adhere to CLPCCD and College Policies, Procedures and Processes.
REQUIRED SIGNATURES
Print Advisor Name: _________________________________ Advisor Signature: ______________________
Print Co-Advisor Name: ___________________________ Co-Advisor Signature:______________________
PRINT NAMES AND STUDENT ID #s FOR CLUB MEMBERS (use reverse for add’l names)
1. __________________________ ____________ 5. __________________________ ____________
Name ID Name ID
2. __________________________ ____________ 6. __________________________ ____________
Name ID Name ID
3. __________________________ ____________ 7. __________________________ ____________
Name ID Name ID
4. __________________________ ____________ 8. __________________________ ____________
Name ID Name ID
TO RECEIVE ICC FUNDS, CLUB MUST COMPLETE THESE ITEMS
Date Received by ICC
● Club Constitution ______________
● Completed LPCSG Club Form ______________
● Club Procedures Training Verification _________________
PETITION APPROVAL
Date of 1
st
Club Proposal: __________________ Date Approved by ICC: _________________________
Date Club Account No. Requested: ___________ Date Club Copy Code Requested: __________________
Director of Student Life: _____________________________________ Date: _________________
VP of Student Services: _____________________________________ Date: __________________
CLUB CONSTITUTION OUTLINE ATTACHED – PLEASE COMPLETE
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