Fillable STUDENT ACTIVITY REQUEST FORM (Louisiana Delta Community College)

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STUDENT ACTIVITY REQUEST FORM (Louisiana Delta Community College)

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The STUDENT ACTIVITY REQUEST FORM (Louisiana Delta Community College) form is 1 page long and contains:

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  • 10 check-boxes
  • 22 other fields

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File type: PDF

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Date Submitted: __________________________ Name of Club/Organization: _____________________
Submitted by: ____________________________ Title: ___________________________________________
Date of Activity: ____________________ Time: ___________ Title of Activity: _____________________
Location of Activity: _______________________________________________________________________
Contact Person: _____________________________ Phone #: _________________________________
Nature of Activity: ________________________________________________________________________
_____ ______
Number of members expected to attend activity:
_______ _______ _______
______________________________________________
_______
Number of students/faculty/staff/general public expected to attend activity: _____________________
Please list the sponsor(s) for the planned activity: ______________________________________________
__________ __________
__________ __________
__________ __________
________________________________ Date: _________________________
Club/Organization Sponsor: _________________________________ Date: _________________________
Dean Student Success Services: _______________________________ Date: _________________________
Club/Organization President:
COLLEGE
LOUISIANA DELTA COMMUNITY
DIVISION OF STUDENT AFFAIRS
STUDENT SUCCESS SERVICES DEPARTMENT
STUDENT ACTIVITY REQUEST FORM
Is this a fund raiser activity? Yes No
If yes, please complete the club and organization fundraiser form A before the event and B after
the event.
This activity is open to (check all that apply):
Member Only Student Body Faculty/Staff General Public
Please indicate the avenues used to promote this activity:
Chalk
Flyers
NewsStar
Banners
Invitations
Other Campus Media
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STUDENT ACTIVITY REQUEST FORM (Louisiana Delta Community College)

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Completed 16 September 2020

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