UIC

OFFICER'S INFORMATION PAGE

ACADEMIC YEAR 2008-2009



Details of the person filling out this form Name: Email:

OFFICIAL NAME OF THE ORGANIZATION:
(Must exactly the same on all the forms)
Side registered to : East Side West Side
Please select the Number Code and Title Code of your organization:


FACULTY ADVISOR DETAILS:
Name: Phone:
(Please enter as x-xxxx)
Department: Email Address:
Office Room Building: Mail Code:


PRESIDENT or TITLE of 1st OFFICER POSITION
Name: Phone:
(Please enter as xxx-xxx-xxxx)
UIN#: Email Address:
Current Street Address: City: State: ZipCode:


TREASURER or TITLE of 2nd OFFICER POSITION
Name: Phone:
(Please enter as xxx-xxx-xxxx)
UIN#: Email Address:
Current Street Address: City: State: ZipCode:


VICE PRESIDENT or TITLE of 3rd OFFICER POSITION
Name: Phone:
(Please enter as xxx-xxx-xxxx)
UIN#: Email Address:
Current Street Address: City: State: ZipCode:


TITLE of 4th OFFICER POSITION
Name: Phone:
(Please enter as xxx-xxx-xxxx)
UIN#: Email Address:
Current Street Address: City: State: ZipCode:


TITLE of 5th OFFICER POSITION
Name: Phone:
(Please enter as xxx-xxx-xxxx)
UIN#: Email Address:
Current Street Address: City: State: ZipCode:


TITLE of 6th OFFICER POSITION
Name: Phone:
(Please enter as xxx-xxx-xxxx)
UIN#: Email Address:
Current Street Address: City: State: ZipCode:


TITLE of 7th OFFICER POSITION
Name: Phone:
(Please enter as xxx-xxx-xxxx)
UIN#: Email Address:
Current Street Address: City: State: ZipCode: