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PVCC New Student Club/Organization Interest Form
All information on this form must be completed for consideration, including name of faculty/staff member who will serve as an advisor.
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* Indicates required question
Applicant Name
*
Your answer
Applicant E-mail Address and Cell Phone
*
Your answer
Proposed Club Name
*
Your answer
Proposed Club/Organization Mission Statement:
*
Your answer
Proposed Name of Faculty/Staff Advisor:
*
Your answer
Faculty/Staff Advisor Email Address
*
Your answer
How will this club/organization benefit/contribute to student life at PVCC?
*
Your answer
Number of interested participants?
*
1-5
6-10
11-15
16-20
Other:
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