WEST VIRGINIA UNIVERSITY
STUDENT ORGANIZATION SERVICES
PETITION FOR STUDENT ORGANIZATION
UNIVERSITY RECOGNITION
DATE_________________________
NAME OF ORGANIZATION_______________________________________________
MAILING ADDRESS_____________________________________________________
______________________________________________________________________
E-MAIL ADDRESS_______________________________________________________
WEBSITE ADDRESS_____________________________________________________
CLASSIFICATION (CIRCLE ALL THAT APPLY)
AFFILIATION
NAME AND ADDRESS OF ORGANIZATION WITH WHICH AFFILIATED:
______________________________________________________________________________________________________________________________________
___________________________________________________________________
PURPOSE_____________________________________________________________
______________________________________________________________________
MEMBERSHIP QUALIFICATIONS__________________________________________
______________________________________________________________________
CURRENT MEMBERSHIP SIZE______________________
FINANCES: INITIATION FEE______________________
ANNUAL DUES_______________________
BANK ACCOUNT(S):
CHECKING ACCOUNT#__________________
SAVINGS ACCOUNT#___________________
SCHEDULED MEETINGS:
Location____________________________________________________
Frequency__________________________________________________
Day & Time_________________________________________________
ELECTIONS: Month of Election__________________________________
Term of Office_____________________________________
OFFICERS: (Must be full time student, at WVU Morgantown, with at least a 2.0 cumulative G.P.A.)
PRESIDENT
Name___________________________________________________________
Address__________________________________________________________
Phone___________________________________________________________
E-Mail___________________________________________________________
VICE PRESIDENT
Name___________________________________________________________
Address__________________________________________________________
Phone___________________________________________________________
E-Mail___________________________________________________________
SECRETARY
Name___________________________________________________________
Address__________________________________________________________
Phone___________________________________________________________
E-Mail___________________________________________________________
TREASURER
Name___________________________________________________________
Address__________________________________________________________
Phone___________________________________________________________
E-Mail___________________________________________________________
ADVISOR (Must be a full time staff member. Medical Corporation employees are not eligible)
Name___________________________________________________________
Department_______________________________________________________
Position__________________________________________________________
Address__________________________________________________________
Phone___________________________________________________________
E-Mail___________________________________________________________
PRESIDENT’S STATEMENT: "I certify that the preceding information is accurate. I have read the Requirements for Student Organizations, the West Virginia University Code of Student Rights and Responsibilities, and the West Virginia Anti-Hazing Law, and I understand that as the president of this organization, I can be held responsible for its actions"
___________________________________________
President’s Signature Date
___________________________________________
President’s Printed Name Date
ADVISORS:
ADVISOR’S STATEMENT: "I have examined this student organization petition and the attached copy of the constitution, and I am willing to serve as advisor to this organization."
____________________________________________
Advisor’s Signature Date
____________________________________________
Advisor’s Printed Name Date
IF THE ORGANIZATION IS IN ANY WAY AFFILIATED WITH A COLLEGE, SCHOOL, OR DEPARTMENT, THE AUTORIZATION OF THE DEAN, DIRECTOR, OR CHAIR MUST BE OBTAINED.
DEAN OR DIRECTOR STATEMENT: "I have examined this student organization’s petition and the attached copy of the constitution and authorize their status as a student organization within our college/school."
__________________________________________
Dean/Director’s Signature Date
__________________________________________
Dean/Director’s Printed Name Date
__________________________________________
School, College or Department Date