C-Hill Club Request
View the club guidelines at http://www.chs.4j.lane.edu/clubs. NOTE: The staff adviser MUST be present for ALL meetings.
Name of Club *
Students Requesting Club
5-student minimum - you can use current members. All club members must possess a student ID card with an ASB sticker and pay any club fees.
1. *
2. *
3. *
4. *
5. *
Total Number of Members
*Adviser must be a school staff member or approved adult over the age of 21.*
Non-4J employees MUST complete a district volunteer and criminal background check form.
Adviser Signature *
By typing my name below, I acknowledge that I have read the club formation guidelines (http://www.chs.lane.edu/students/student-resources/clubs/) and agree to serve in the capacity of club adviser for this club.
Adviser Phone *
Clear selection
Adviser Email Address *
Club President/Captain
President Name *
President Phone *
President Email *
Club Details
Purpose of the Club *
Membership Requirements *
Meeting Time and Location *
Example: Mondays at lunch in J12
Club Sports Insurance *
A certificate of insurance must be submitted to the office before a club sport can be approved.
Will you be fundraising?
Fundraisers held at the school must be pre-approved by the Operations Committee.
Clear selection
Funding Amount Requested from ASB
Submit for Approval
Check with the Administrator in charge of clubs (Misael Flores) in one week for approval.
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