| Semester and year (e.g. Fall 2005) : |
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| Official organization name: |
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| Organization's or president's email address (if applicable): |
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| Number of current members: |
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| Is this group a local chapter of a national/international organization? |
Yes
No |
Officers |
| President's Full name: |
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| President's email address: |
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| President's student ID number: |
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| President's local mailing address: |
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| President's local phone number: |
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| Vice President's Full name: |
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| Vice President's email address: |
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| Vice President's student ID number: |
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| Vice President's local mailing address: |
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| Vice President's local phone number: |
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| Secretary's Full name: |
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| Secretary's email address: |
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| Secretary's student ID number: |
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| Secretary's local mailing address: |
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| Secretary's local phone number: |
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Declaration of Advisor |
| Faculty/staff advisor name: |
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| University department/office: |
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| Campus email address (if applicable): |
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| Campus phone number |
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| |
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| Faculty/staff advisor name: |
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| University department/office: |
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| Campus email address (if applicable): |
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| Campus phone number |
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We hereby certify that the above-named organization will abide by and conduct all activities in accordance with state and federal law, the organization constitution and bylaws, and policies and procedures governing student organizations as formulated by The University of Tennessee at Martin and stated in the Student Handbook, Additionally, we, the undersigned certify that organization membership cu rrently includes at least ten (10) or more students currently enrolled at The University of Tennessee at Martin and verify that the information appearing on this form is true and correct to the best of our knowledge. This information may be released for directory and mailing purposes, The Office of Student Life will receive written notification of any changes in the organizational constitution and bylaws, officers, advisors, or general status. |
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Membership Roster |
Semester and year (e.g. Fall 2005) :
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| Name of Organization: |
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| Advisor(s): |
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| |
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| Member's names, email, and campus address: |
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