Tennessee State University



Tennessee State University

Organization Registration Form

Student Government Association

New Registered Organization Re-Registering Organization

School Year Date Submitted

I. Name of Organization

Please Check All that Apply

Academic

City or State Club

Creative Arts (i.e. Dance, Drama, Modeling, Music)

Department

Gender-specific Male Female

Greek-Lettered

Mentoring

Pan-Hellenic

Professional (i.e. Business, Law)

Religious

Residence Hall

Service

A. If organization is a Department Organization, please indicate the department and department head

(Department)

(Department Head)

B. If organization is an affiliate of a national body, please fill in below:

Name of Regional Director

Address

Street Number City State Zip

Name of National Body

Address

Street Number City State Zip

C. Do You Have an Intake Process?

Yes No

II. Number of Members

III. Frequency of Meetings

IV. Place

V. Time

VI. Organization’s Mailing Address and/or Campus P.O. Box

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VII. Officers & Advisors

Note: List All Officers and Advisors with Accurate Contact Information (Print)

|Name |Title |Ph. Number |Email |

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VIII. Organization Profile

Note: Please Provide a Statement of Purpose of Organization and a Brief Description of Activities, constitution, and Regular Events of Organization (Provide Attachment if Necessary) _______

Registration Fees:

Small Org. (5-20 members) $ 50.00

Med Org. (21-40 members) $ 75.00

Large Org. (41-above members) $ 100.00

Organization’s President’s Signature

Organization Advisor’s Signature

*NOTE: Return to Student Activities- FPCC Room 209, or, P.O. Box 9548

Approved: (SGA Vice President)

Approved: (Student Activities Director)

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