Wayne State University

AIM HIGHER

Dean of Students Office
5221 Gullen Mall
351 Student Center
(313) 577-1010
doso@wayne.edu

HOME > RECOGNITION FORM

2009-2010 Student Organization
Recognition Form
* = required field

If your officers change after completing this form, you must complete the Officer Change Form and e-mail the completed form to: aj2962@wayne.edu

NOTE: If a new president is elected during the academic year, you must resubmit this form.

NEW POLICY: In Section IV, please complete the information requested for members, other than officers, to be authorized to reserve rooms, literature tables, showcases, bake sales, as well as sign Event Planning Forms (EPF). The members listed in Section IV will NOT be able to authorize university financial forms. Only designated officers may conduct financial transactions for the group.

PART I: Student Organization Information

Full Name of Organization:
*
No Acronyms Please

Category:
*

Campus Address:
(This address will be published)

*
Please include:
Street Address, Building, Room Number/Mailbox Number in the Student Center Building

Office Phone/Public Number:
(This number will be published)
*

Web Address:
(This address will be published)

Group E-mail
(if applicable):
(This address will be published)

Advisor:
Cannot be
DOSO staff *

Advisor Phone: *

Advisor
E-mail:

Web Coordinator Name (if applicable):

Web Coordinator
Student ID #:

Web Coordinator Phone:

Part II: List ALL Officers
(as stated in your constitution)
INFORMATION MUST BE COMPLETE AND ALL OFFICERS MUST BE CURRENTLY REGISTERED WSU STUDENTS. Only names of the officers and their positions will be published.

Officer #1 Name: *

Officer #1
Student ID #: *

Officer #1 Position: *

Officer #1
Home Address: *

Officer #1 City: *

Officer #1 State: *

Officer #1
Zip Code: *

Officer #1
Home Phone: *

Officer #1
E-mail: *

Is Officer #1 authorized to sign financial and other university forms on behalf of this organization?:

Yes
No *

Part III: Additional Officers

Officer #2 Name: *

Officer #2
Student ID #: *

Officer #2 Position: *

Officer #2 Home Phone: *

Officer #2
E-mail: *

Is Officer #2 authorized to sign financial and other university forms on behalf of this organization?:

Yes
No *

Officer #3 Name:

Officer #3
Student ID #:

Officer #3 Position:

Officer #3 Home Phone:

Officer #3
E-mail:

Is Officer #3 authorized to sign financial and other university forms on behalf of this organization?: Yes
No

Officer #4 Name:

Officer #4
Student ID #:

Officer #4 Position:

Officer #4 Home Phone:

Officer #4
E-mail:

Is Officer #4 authorized to sign financial and other university forms on behalf of this organization?: Yes
No

Officer #5 Name:

Officer #5
Student ID #:

Officer #5 Position:

Officer #5 Home Phone:

Officer #5
E-mail:

Is Officer #5 authorized to sign financial and other university forms on behalf of this organization?: Yes
No

Officer #6 Name:

Officer #6
Student ID #:

Officer #6 Position:

Officer #6 Home Phone:

Officer #6
E-mail:

Is Officer #6 authorized to sign financial and other university forms on behalf of this organization?: Yes
No

Officer #7 Name:

Officer #7
Student ID #:

Officer #7 Position:

Officer #7 Home Phone:

Officer #7
E-mail:

Is Officer #7 authorized to sign financial and other university forms on behalf of this organization?: Yes
No

Officer #8 Name:

Officer #8
Student ID #:

Officer #8 Position:

Officer #8 Home Phone:

Officer #8
E-mail:

Is Officer #8 authorized to sign financial and other university forms on behalf of this organization?: Yes
No

Officer #9 Name:

Officer #9
Student ID #:

Officer #9 Position:

Officer #9 Home Phone:

Officer #9
E-mail:

Is Officer #9 authorized to sign financial and other university forms on behalf of this organization?: Yes
No

Officer #10 Name:

Officer #10
Student ID #:

Officer #10
Position:

Officer #10 Home Phone:

Officer #10
E-mail:

Is Officer #10 authorized to sign financial and other university forms on behalf of this organization?: Yes
No

Part IV: Authorized Members

Member #1 Name:

Member #1
Student ID #:

Member #1 Home Phone:

Member #1
E-mail:

Member #2 Name:

Member #2
Student ID #:

Member #2 Home Phone:

Member #2
E-mail:

Member #3 Name:

Member #3
Student ID #:

Member #3 Home Phone:

Member #3
E-mail:

Member #4 Name:

Member #4
Student ID #:

Member #4 Home Phone:

Member #4
E-mail:

Member #5 Name:

Member #5
Student ID #:

Member #5 Home Phone:

Member #5
E-mail:

Member #6 Name:

Member #6
Student ID #:

Member #6 Home Phone:

Member #6
E-mail:

Member #7 Name:

Member #7
Student ID #:

Member #7 Home Phone:

Member #7
E-mail:

Member #8 Name:

Member #8
Student ID #:

Member #8 Home Phone:

Member #8
E-mail:

Member #9 Name:

Member #9
Student ID #:

Member #9 Home Phone:

Member #9
E-mail:

Member #10 Name:

Member #10
Student ID #:

Member #10 Home Phone:

Member #10
E-mail:

Part V: Agreement Terms

Approximate Number of Active Members: *

Please list three goals your group wants to accomplish this year.
1.    *
Mandatory Field

2.    *
Mandatory Field

3.    *
Mandatory Field

AGREEMENT STATEMENT:

1) Recognition of this organization by Wayne State University as a student organization makes the organization eligible for certain benefits respecting the use of University facilities and resources. It does not constitute the organization as a department agent, affiliate or part of Wayne State University.

2) To the best of my knowledge, ALL of the full members of this organization are registered students at Wayne State University.

3) I have read and understand the Dean of Students Office policies and procedures detailed in the "Information and Financial Manuals" at: www.doso.wayne.edu/reference.

I HAVE READ AND AGREE TO THE PRECEEDING THREE CONDITIONS AS REQUIRED FOR UNIVERSITY RECOGNITION

Agreement to Terms Above: Yes, I agree to these terms *

Current Month: *

Current Year: *

Description of this Organization/Group:
(This information will be published)

( You may enter up to 1000 characters. )
*
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