Jackson Community College
Student Life JCC New Student Organization Form *Thank you for your interest in starting a new campus organization. Please fill out this form. Doing so will assure you formal consideration from your JCC Student Parliament as a potential organization on campus. Completed forms can be turned in to Steve Bloomfield, Director of Student Life at the Fieldhouse. Name of Organization: _____________________________________ Primary Contact Information: Name: _________________________________ Phone Number: ____________________Email: _____________________ Advisor:__________________________________ Phone Number:__________________________ Email:_____________________ Meeting time and location: ________________________________ Interest Group Membership: Name and Email Address (please attach additional members):
General Purpose of the group: ______________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ |