Mt. SAC Club Information Form

To become or remain an active club, please complete the following form and ensure all requirements below are met.

OFFICERS MUST:

Be currently enrolled in five Mt. SAC graded, paid, credit units during the time of office;
Have paid the current Student Activities fee and;
Have a Mt. SAC cumulative 2.5 GPA (per Associated Students Constitution; Article V, Section 1);
Maintain a minimum 2.0 semester GPA. No Mt. SAC student may serve as a club officer for more than four semesters.

INSTRUCTIONS & SUPPORTING DOCUMENTS:

Print legibly.
Attach copies of current student schedules/receipts, which show that officers have paid the current Student Activities fee (#11 in the student portal).
Submit copies of current Mt. SAC academic transcripts (#18 in the student portal).

Attention Advisors: Please return ALL documents in a sealed envelope (receipts & transcripts) along with this completed form to Barbara Carrillo in the Student Life Office (9C), you may have a student deliver by Monday, March 21st, 2015 at 5:00 p.m.

Club Information Form

*Today's Date (click to view calendar)

Students who would like to learn more about your club should have reliable contact information. Please provide us with the person best to contact to provide prospective club members and students-at-large information about the club. Note: we will be posting this information on the Associated Students club webpage.

*Club Name:

*Club Contact's Full Name (must be an officer or advisor):

Club Contact's Title (must be an officer or advisor):

*Club Contact's E-Mail Address:

In accordance with Mt. SAC Administrative Procedure 3720-Use of Technology and Information Resources, all clubs must report the Titles and web addresses of all websites and social networking pages/groups to Student Life. An advisor MUST BE AN ADMINISTRATOR on each account. Examples: Club Website, facebook.com, Twitter.com, Instagram, etc.

Network Name:

User, Group, or Page Title:

Web Address:

Network Name:

User, Group, or Page Title:

Web Address:

Network Name:

User, Group, or Page Title:

Web Address:

Network Name:

User, Group, or Page Title:

Web Address:

Network Name

User, Group, or Page Title:

Web Address:

Student Officers Acknowledgement: By entering the information below, you hereby authorize the Student Life Office and Club Advisor(s) to check your eligibility as a club officer.

*Club President's Name

*Student ID

*Phone Number

*E-Mail Address

*Club Vice President's Name

*Student ID

*Phone Number

*E-Mail Address

*Club Secretary's Name

*Student ID

*Phone Number

*E-Mail Address

*Club Treasurer's Name

*Student ID

*Phone Number

*E-Mail Address

*ICC Representative's Name

*Student ID

*Phone Number

*E-Mail Address

Please visit the club website for important dates of attendance: http://mtsac.edu/clubs/icc.html

ICC Representatives
*The ICC Rep. must be available to attend ICC meetings. Meetings are held on the 1st and 3rd Mondays of the month from 2:30 – 3:30 p.m. in Building 9C Stage.

The Faculty member(s), permanent Classified Professional(s), or Manager(s) listed below will serve as Advisor to the above named club for the current semester. Advisors agree to the following:

To be present at all club meetings and activities, both on campus and off.

To provide advice, guidance, and support to the club members.

To advise students and uphold policies and regulations set forth by the District, Student Life Office, Associated Students, and the Inter-Club Council as they pertain to student clubs.

To ensure that all funds of the club are properly collected, deposited, and accounted for through the Fiscal Services Office. No off-campus accounts are permitted.

*Advisor's Name

*E-Mail Address

*Phone Number

Employee Status

*Advisor's Name

*E-Mail Address

*Phone Number

*Employee Status

*Advisor's Name

*E-Mail Address

*Phone Number

Employee Status