Student Organization Information Form, 2013-2014
This form is so the Office of Student Life and Development may contact your organization regarding all club related purposes. Information on this form will only be used for office purposes and may be shared with the Treasurer and  Vice President of the Student Government Association. The information will not be shared with the public.

Please complete the following form about your organization. Fields left with "unknown or N/A" will not be accepted as complete.

For questions or comments, please contact the Club Coordinator, Christina Cross, Ccross@citytech.cuny.edu, 718.260.5391
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Organization Name *
Purpose/Description of Organization *
Type of Organization *
How many years has the club existed? *
President's First Name *
President's Last Name *
Vice President's First Name *
Vice President's Last Name *
Treasurer's First Name *
Treasurer's Last Name *
Secretary's First Name *
Secretary's Last Name *
Faculty Advisor's First Name *
Faculty Advisor's Last Name *
President's E-mail *
Please provide the e-mail used most.
Vice President's E-mail *
Please provide the e-mail used most.
Treasurer's E-mail *
Please provide the e-mail used most.
Secretary's E-mail *
Please provide the e-mail used most.
Faculty Advisor's E-mail *
Please provide the e-mail used most.
President's Phone Number *
Please provide the number used most.
Vice President's Phone Number *
Please provide the number used most.
Treasurer's Phone Number *
Please provide the number used most.
Secretary's Phone Number *
Please provide the number used most.
Faculty Advisor's Phone Number *
This can be a campus phone number.
President's Address *
Vice President's Address *
Treasurer's Address *
Secretary's Address *
Faculty Advisor's Address *
This can be the advisor's office address.
President's City of Residence *
Vice President's City of Residence *
Treasurer's City of Residence *
Secretary's City of Residence *
Faculty Advisor's City of Residence *
President's State of Residence *
Vice President's State of Residence *
Treasurer's State of Residence *
Secretary's State of Residence *
Faculty Advisor's State of Residence *
President's Zip Code *
Vice President's Zip Code *
Treasurer's Zip Code *
Secretary's Zip Code *
Faculty Advisor's Zip Code *
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