Student Organization Recognition Form

Black Hills State University

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Student Organization Recognition Form

Organization Information

Organization Name:

Organization Category:

Web Site:

Meeting Information:

Organization Description:

Please indicate how many individuals in the following categories are actively involved with your organization.

Students:

Faculty:

Staff:

Community Members:

Please attach a list of your members, including officers:

Primary Student Contact Information

First Name:

Last Name:

Email Address:

Phone Number:

Organization Advisor Information

Advisor Name:

Advisor Email:

Advisor Phone:

Advisor Office:

Advisor Unit #:

CONTACT INFORMATION:
Black Hills State University
Student Union & Activities
1200 University St. Unit 9000
Spearfish, SD 57799-9000
1.605.642.6378
susie.leahy@bhsu.edu

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