2012 - 2013 Northwest Organization Recognition Form
Please fill out all fields with as complete information as possible, including contact information for Executive Members and Advisors.  Student Senate will then discuss your application when Senate meets - Tuesday evenings at 7pm in the Student Union.  Student Senate representatives will notify Advisors and Presidents whether organization has been approved.
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Official Name of Organization *
Please list the full name as you would like for it to appear on the Website
Was this Organization Officially Registered with Student Senate and Recognized during the 2011-2012 Academic Year? *
Advisor's/Sponsor(1)'s First and Last Name *
Advisors/Sponsors must be full time faculty or staff at Northwest.  Please include complete contact information, including email address and office phone number.
Advisor's/Sponsor(1)'s Northwest Email Address *
Please provide NORTHWEST email address; This address will be added to the MyNorthwest Student Orgs workgroup to receive announcements.
Advisor's/Sponsor(1)'s Campus Address and Phone Number *
Example: Office of Campus Activities (660) 562-1226 (not cell)
Advisor's/Sponsor(2)'s First and Last Name
Advisors/Sponsors must be full time faculty or staff at Northwest.  Please include complete contact information, including email address and office phone number.
Advisor's/Sponsor(2)'s Northwest Email Address
Please provide NORTHWEST email address; This address will be added to the MyNorthwest Student Orgs workgroup to receive announcements.
Advisor's/Sponsor(2)'s Campus Address and Phone Number
Example: Office of Campus Activities (660) 562-1226 (not cell)
Mission
Purpose
President's/Co-President(1)'s or Equivalent Executive Member's First and Last Name *
This student MUST be a full-time, currently enrolled Northwest student.
President's/Co-President(1)'s or Equivalent Executive Member's Northwest Emal *
Please provide NORTHWEST email; this email address will be added to the MyNorthwest Student Orgs workgroup and will receive announcements.
President's/Co-President(1)'s or Equivalent Executive Member's Cell Phone Number *
Please provide cell phone number in this format (_ _ _)- _ _ _ - _ _ _ _.
Co-President(2)'s or Equivalent Executive Member's First and Last Name
Please give first and last name - This student MUST be a full-time, currently enrolled Northwest student.
Co-President(2)'s or Equivalent Executive Member's Northwest Email
Please provide NORTHWEST email; this email address will be added to the MyNorthwest Student Orgs workgroup and will receive announcements.
Co-President(2)'s or Equivalent Executive Member's Cell Phone Number
Please provide cell phone number in this format (_ _ _)- _ _ _ - _ _ _ _.
Vice-President's or Equivalent Executive Member's Information
Please give full name and include contact information including NORTHWEST email and cell phone number
Secretary's or Equivalent Executive Member's Information
Please give full name and include contact information including NORTHWEST email and cell phone number
Treasurer
Please gie full name and include contact information including NORTHWEST email and cell phone number
Additional Officers *
Please Include Position Title, First and Last Name, Northwest Email and Cell Phone Number (_ _ _) - _ _ _ - _ _ _ _.
Number of Meetings Per Month *
Meeting Day and Time
Example: "First Tuesday of Month, 7pm" or "Each Wednesday, 5pm"
Meeting Location
Please be specific if possible (if you have already reserved space).
Number of Members (Approximately) *
Please list current number of members.
Date of elections for leadership positions (approximately) *
Example: End of April
Location of Funds *
Northwest Student Organizations are STRONGLY encouraged to bank ON CAMPUS.  For Information regarding how to set up an account, please call the Bursar's Office at (660) 562-1226.
Funding Sources *
Fee/Dues Required Per Member (If Applicable)
Fund Collection Frequency
Organization Classification *
Pick only one; Your Organization will be classified this way on the Website
Does your organization recognize members and/or community members via an awards process? *
If Yes, please describe awards categories/process
Organization's Agreement to Northwest's Anti-Hazing Policy *
By signing for the above named organization, we hereby agree to adhere to Northwest's Anti-Hazing Policy and further agree to educate our organization on this policy:   In addition to Missouri State Law, Northwest Missouri State University also has accepted and recognizes the definition of hazing by the  Fraternity Executive Association as any intentional action taken or situation created, whether on or off University premises, that produces mental or physical discomfort, embarrassment, harassment, or ridicule. This includes, but is not limited to: paddling in any form, creation of excessive fatigue, physical or psychological shocks, wearing apparel in public stunts and buffoonery, morally degrading or humiliating games and activities, involuntary labor, or any activity not consistent with Northwest Missouri State University and the Student Conduct Code.  The express implied consent of the victim will not be a defense.  Apathy or acquiescence in the presence of hazing are not neutral acts and may be considered violations of this policy.    Hazing of individuals as members or perspective members of any campus entity shall not be tolerated.  Campus entities include any group of persons operating under the name Northwest Missouri State University as employees, students, alumni, friends, or other association.  They include, but are not limited to, residence hall living groups, athletic teams, fraternal Greek organizations, honorary societies, performing arts groups and recognized campus organizations.    Northwest Missouri State University will investigate any incident in which a charge of hazing has been made.  Investigations will be conducted by University Police and, if warranted, will be forwarded to the university’s judicial process.  University recognition may be temporarily withdrawn pending hearings and due process procedures.   Should it be determined that a student organization or any of its members is guilty of hazing as previously defined, university sanctions may include but are not limited to:  1) Automatic and indefinite suspension of campus recognition with an accompanying loss of all campus privileges, (i.e. use of facilities, student services, etc.)  2) Disciplinary action against those members involved in the incident(s) including suspension or expulsion from the University.      
Organization's Agreement to Northwest's Anti-Hazing Policy *
By signing for the above named organization, we hereby agree to adhere to Northwest's Anti-Hazing Policy and further agree to educate our organization on this policy:   In addition to Missouri State Law, Northwest Missouri State University also has accepted and recognizes the definition of hazing by the  Fraternity Executive Association as any intentional action taken or situation created, whether on or off University premises, that produces mental or physical discomfort, embarrassment, harassment, or ridicule. This includes, but is not limited to: paddling in any form, creation of excessive fatigue, physical or psychological shocks, wearing apparel in public stunts and buffoonery, morally degrading or humiliating games and activities, involuntary labor, or any activity not consistent with Northwest Missouri State University and the Student Conduct Code.  The express implied consent of the victim will not be a defense.  Apathy or acquiescence in the presence of hazing are not neutral acts and may be considered violations of this policy.    Hazing of individuals as members or perspective members of any campus entity shall not be tolerated.  Campus entities include any group of persons operating under the name Northwest Missouri State University as employees, students, alumni, friends, or other association.  They include, but are not limited to, residence hall living groups, athletic teams, fraternal Greek organizations, honorary societies, performing arts groups and recognized campus organizations.    Northwest Missouri State University will investigate any incident in which a charge of hazing has been made.  Investigations will be conducted by University Police and, if warranted, will be forwarded to the university’s judicial process.  University recognition may be temporarily withdrawn pending hearings and due process procedures.   Should it be determined that a student organization or any of its members is guilty of hazing as previously defined, university sanctions may include but are not limited to:  1) Automatic and indefinite suspension of campus recognition with an accompanying loss of all campus privileges, (i.e. use of facilities, student services, etc.)  2) Disciplinary action against those members involved in the incident(s) including suspension or expulsion from the University.      
President/Co-President or equivalent Executive Member Signature *
By signing this form I hereby atest to the above information being complete and correct to the best of my knowledge.  I further acknowledge it is the responsibility of my organization to update the information contained herein as it changes by accessing the Student Senate website and re-submitting information periodically.
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