B E L L E V U E C O L L E G E

3 0 0 0 L a n d e r h o l m C i r c l e S E ,B e l l e v u e W A 9 8 0 0 7 - 6 4 8 4

Questions? asgajea@bellevuecollege.edu

studprog@bellevuecollege.edu or visit C212

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CLUB CHARTERING APPLICATION Thank you for your willingness in being involved in Student Program! Before you can start your exciting activities, please fill out the required information about your club.

Today’s Date: What do you up to? new charter re-charter

BASIC INFORMATION

Name of the Club: Faculty/staff advisor name:

Advisor’s e-mail address: Office Location: Extension:

CLUB VISION, MISSION, AND GOALS

VISION Define the optimistic view of the club’s preferred future state.

MISSION Provide purpose and describe how the club will achieve its vision. Emphasize values, culture, and priorities of the club.

GOALS Specify the objectives that will support the mission and help to attain the vision of the club.

HOW DO YOUR CLUB’S VISION, MISSION AND GOALS BENEFIT BELLEVUE COLLEGE STUDENTS AND/OR COMMUNITY?

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CLUB ROSTER (required)

By including the contact information below, you approve these names, with their phone numbers and e-mail addresses to hereby be displayed in the ASBC club list serve. The ASBC club list serve will be

used by students who are interested in joining your club, in addition to ASBC updates, and club event/activity information. Each club is required to provide contact information so that both

interested students as well as Student Programs staff may contact your club.

MAIN CONTACTS These e-mail addresses below would be the e-mail addresses you want people to contact by when they need to contact your club. It does not have to be the e-mail address of the club’s leader(s); it can be

the club’s e-mail address (e.g clubname@mailserver.com). The secondary contact person is optional. If you are using club e-mail addresses, then the contact persons’ names and IDs is preferred to be the

one(s) assigned with the club’s e-mail addresses. Student ID number will not be published.

Main contact person (First name, Last name): Student ID #:

Email address: Phone number:

Secondary contact person (First name, Last name): Student ID #:

Email address: Phone number:

MEMBERS INFO Members Info includes the main contacts as well, with their Bellevue College or personal e-mail

addresses, whichever preferred. These contact information below will be used for Judicial Board’s use and not to be published without any consent of the student.

Member #1 (First name, Last name): Student ID #:

Email address: Phone number:

Member #2 (First name, Last name): Student ID #:

Email address: Phone number:

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Member #3 (First name, Last name):

Student ID #:

Email address: Phone number:

Member #4 (First name, Last name): Student ID #:

Email address: Phone number:

Member #5 (First name, Last name): Student ID #:

Email address: Phone number:

ASBC CLUB AGREEMENT

I have read, understand and agree to the ASBC Club/Programs Policies and Procedures. Further, I have read, understand and agree to the ASBC Code of Ethics. I understand that club members must follow the ASBC Club/Programs Policies and Procedures as well as the ASBC Code of Ethics. In addition, I agree that the club is subject and will adhere to the ASBC Constitution, ASBC By-Laws, ASBC Financial Code, ASBC Code of Ethics and all other applicable BC Policies and Procedures.

I understand that if our club is found to be in violation of any of the policies, rules and procedures contained in the aforementioned documents that our club will face punitive action including but not limited to: warning, probation, charter revocation and or freezing/seizure of ASG club funds.

I, acting on behalf of said club, do hereby agree to the above.

x

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(print name)

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ADVISOR AGREEMENT I have read and understand the ASBC Club Policies and Procedures. As an advisor for this ASBC chartered club I will maintain a relationship with club leaders, and keep current with all BC and Student Program policies that may affect the club.

x

To be completed by Student Programs Personnel

Received by:

Date Charter approved by Judicial Board Initial:

Form updated 11-07-2013 by ASG Associate Justice of External Affairs

(print name)