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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.
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* Required
Name of Club
*
Your answer
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.
Founding Club Members
*
List the names of the first 5 club members.
Your answer
Total Number of Members
Your answer
Adviser
*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.
Your answer
Adviser Phone
*
Your answer
Cell
Home
Work
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Adviser Email Address
*
Your answer
Club President/Captain
President Name
*
Your answer
Club Details
Purpose of the Club
*
Your answer
Membership Requirements
*
Your answer
Meeting Time and Location
*
Example: Mondays at lunch in J12
Your answer
Club Sports Insurance
*
A certificate of insurance must be submitted to the office before a club sport can be approved.
Yes
No
N/A
Will you be fundraising?
Fundraisers held at the school must be pre-approved by the Operations Committee.
Yes
No
Clear selection
Funding Amount Requested from ASB
Optional
Your answer
Submit for Approval
Check with the Administrator in charge of clubs (Lancelot Falcon) in one week for approval.
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