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University of Houston - Department of Campus Activities

S T U D E N T O R G A N I Z A T I O N R E G I S T R A T I O N F O R M

This Form MUSTBe Typed Registration Expiration Date: AUGUST 31, 2010
A LL INFORMATION ON THIS FORM MUST B E K EPT UPDATED
Organization Name:

Statement of Purpose / Organization Description:

CA Box #: We request a Campus Activites mailbox: Yes or No If no, must provide Campus Mailcode:

Office Phone # (if any): Organization Web address: http://

Organization E-mail address: Is this a new organization?

NOTE: Constitution must be filed with Campus Activities within 30 days.

Type of organization (please check only one):
College/Professional Fraternity/Sorority Honors International/Ethic
Political/Social Action Recreational/Hobbies Religious/Spiritual Special Interest

When do you elect new officers? When do you accept new members?

Membership requirments/Dues:

Organization Officers/Official Representatives MUST Be University of Houston Students

Name**: Signature***:

Title*: UH Email Address**:

Current Address**: People Soft ID: Phone**:

City/State**: Zip**: Alternate Phone (work, pager, etc)**:

Name**: Signature***:

Title*: UH Email Address**:

Current Address**: People Soft ID: Phone**:

City/State**: Zip**: Alternate Phone (work, pager, etc)**:

Name**: Signature***:

Title*: UH Email Address**:

Current Address**: People Soft ID: Phone**:

City/State**: Zip**: Alternate Phone (work, pager, etc)**:

Faculty/Staff Advisor**: Dept:

Campus Mail Code: Phone: E-mail Address:

* Mailboxes are given out as requests are received. There is no guarantee an organization will retain the same mailbox from year to year. Please do
not list the mailbox number as an official address on checks or stationery.
** Information listed here will be circulated as requested unless Campus Activities is notified in writing that it should be withheld.
*** Signature indicates that representatives have read, understand and agree to abide by the Statement of Understanding printed on the back of
this form. This form cannot be processed without all three signatures.

For Department Use Only

Orientation Attended: Date: Constitution on file? Year last updated: Mailbox#:

Enrollment Verified: Approved by: Date:

State Law requires that you be informed of the following: (1) with few exceptions, you are entitled on request to be informed about the information the University collects about you by use of
this form; (2) under sections 552.021 and 552.023 of the Government Code, you are entitled to receive and review the information; and (3) under section 559.004 of the Government Code,
you are entitled to have the University correct information about you that is incorrect. Updated 6 May 2002

GENERAL INFORMATION REGARDING

REGISTERED STUDENT ORGANIZATIONS
A registered student organization is an organization formed and governed by students
enrolled at the University of Houston Central Campus and registered with the
Department of Campus Activities at the University of Houston Central Campus.

Membership in registered student organizations is restricted to currently enrolled

students, faculty, staff and alumni at the University of Houston.

All Student organizations are responsible for reading and abiding by the policies stated in the Student Organizations'
Handbook and the University of Houston Student Handbook.

The signatures on the Student Organization Registration Form certify that the three
officers/representatives have read, understand and agree to abide by the Statement of
Understanding below.
The Registration Form cannot and will not be processed without all three (3) signatures.

STATEMENT OF UNDERSTANDING
We, officers/representatives of the organization listed on the Student Organization
Registration Form (reverse side), are currently enrolled students at the University of
Houston Central Campus.

We agree to read the Student Organizations' Handbook, and certify that this organization will abide by the responsibilities of
registered student organiztions as stated in the Student Organizations' Handbook.

We certify that registered student organiztions have freedom of choice in the selection
of members, provided that there is no discrimination on the basis of race, color,
religion, national origin, sex, age, disability, veteran status, or sexual orientation.

We acknowledge that the University requires all members to be enrolled students,

employees or alumni of the University of Houston Central Campus.

We understand that hazing is a crime under the Penal Code of the State of Texas. We
certify that the organization that we represent will not engage in hazing practices.