Proposed Organization/Club Membership Form

Student Life - Metropolitan Community College

Organization/Club: Date:
Advisor name: Phone:
Advisor name: Phone:
When are your meetings?
How often do you meet? Where?
List ten (10) student who plan to be active members in the organization/club:
1. 6.
2. 7.
3. 8.
4. 9.
5. 10.
Required written signatures:
_________________________________________ _________________________________________
Student Representative Signature, Date Advisory Signature, Date

Please mail all forms to:
Metropolitan Community College
Attn: Campuses and Student Affairs
Fort Omaha Campus Bldg. 30
P.O. Box 3777
Omaha, Nebraska 68103-0777