Faculty/Academic Professional Organization Registration Form

Posted April 8th, 2008 by cameo

This form registers faculty and academic professional organizations operating on the campus and within the structure of the university.

This process is addressed in the Academic Affairs Manual, Policy ACD 810. Please refer to this policy for complete details.

Contact Information: Erika Gallagher, Office of the Executive Vice President and Provost of the University, phone: (480) 965-4995.

After you complete the registration, be sure to click "Submit" to have your information submitted.

Registration Type:

New Registration

Renewal registration

Organization Information

Name of Organization: *

Exactly as identified in organization’s constitution

Name of Contact: *

Email Address of Contact: *

Mail Code:

Officers (Including Organization President)

President

Name:

Title:

Department:

Phone:

Officer 1

Name:

Title:

Department:

Phone:

Officer 2

Name:

Title:

Department:

Phone:

Officer 3

Name:

Title:

Department:

Phone:

Membership

Total Number of members:

Faculty/Academic Professionals (total no.):

Students (total no.):

Time & Place of Regular Meetings

Day & Hour, Place:

Statement of Membership Selection as it Pertains to Race, Color, Creed, or National Origin

This is to certify that the following named faculty/academic professional organization,:

at Arizona State University, Tempe, Arizona is free to extend membership privileges to any faculty member/academic professional without regard to race, color, creed, or national origin, and that it is not restricted by its Constitution, By laws, Rituals, “Gentlemen’s Agreements,” or outside influence so far as it pertains to race, color, creed, national origin, or sexual orientation.

Verified by

Name of Organization Officer:

Title of Organization Officer:

Department:

If this is a NEW registration, please include the following

Statement of Membership Selection:

Cut & paste from a word processing document.

Statement of Purpose OR Constitution with Bylaws:

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Faculty/Academic Professional Organization Registration Form

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