Student Organization Request Form
Use this form to request approval for the creation of a new student club/organization OR change the name of an existing club/organization at RPCC.
Reason for Submission
Please Select
Start a Club
Change Existing Club Name
ORGANIZATION/CLUB NAME
Name Change Requested
Enter the new organization name you'd like to be recognized by.
Organization/Club Focus
Please Select
Program Related
Special Interest
Service
Faith-based
Indicate the category that best describes the interest of this organization/club.
RESPONSIBLE PARTIES
Responsible Student Contact
First Name
Last Name
Email
example@example.com
Student LoLA#
Student ID#
Contact Number
Please enter a valid phone number.
I have reviewed all information outlined in the Student Organization Handbook.
*
Yes
No
Best Appointment Time
Faculty/Staff Advisor Name
First Name
Last Name
Email
example@example.com
Division
Please Select
Student Services
Workforce Education
General Education
Technical Education
Phone Number
Please enter a valid phone number.
Are there multiple advisors?
YES
NO
ORGANIZATION FUNCTION
Indicate how your organization/club plans to receive funding for events, training, travel, etc.?
Funding Source
Membership Dues
Fundraising
RPCC Student Government Association (SGA)
Donations
Other
If membership dues selected, please indicate the intended amount and method of collection here.
Primary Location
Please Select
Gonzales
Reserve
United Way of St. Charles
Westside
All campuses
Is your organization/club affiliated with a national organization?
Please Select
Yes
No
If yes, please list your national headquarters contact information
Is your organization's membership open to all RPCC students?
Please Select
Yes
No
Describe any membership limitations, if applicable.
When will your first meeting be held?
SUPPORTING DOCUMENTS
Required Documents
Browse Files
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Choose a file
(Upload Roster Registration Form, Action Summary Form, or Justification of Change)
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of
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