Laker Life Student Organization Recognition

Laker Life Student Organization Recognition

In accordance with Mid Michigan College’s policies and procedures, the following student organization does hereby request official recognition.
What is the name of the student organization?*
What is your role in the student organization?*

Student LeaderAdvisor
Student Leader Name*

First NameLast Name
Student Leader Mid Mich Email*
example@midmich.edu
Student Leader Phone*

Area CodePhone Number
Advisor Name*

First NameLast Name
Advisor Mid Mich Email*
example@midmich.edu
Advisor Phone*

Area CodePhone Number
What is the Advisors primary role at Mid Michigan College?*

Instructor/FacultyAdministratorHourly Staff Member
Describe the student organization you wish to form.*
Are there any questions or information you would like to share about your student organization?
Signature*

Clear
Today's Date*

MonthDayYear

Director of Student Life Use ONLY
Renewal Application Status*

ApprovedDeniedAdditional Information Needed
What additional information is needed?*
Signature*

Clear
Date*

MonthDayYear
Significant effort has been made to ensure this content meets accessibility guidelines. If you encounter a barrier you can report the barrier at midmich.edu/reportaccessibilitybarrier or contact Laker Life at (989) 386-6634 or lakerlife@midmich.edu.

In its commitment to providing a safe environment, Mid Michigan College actively endeavors to broaden our diversity, promote equal opportunity, and prohibit any form of discrimination in its programs, activities, and conditions of admission or employment. Learn more about these efforts and policies by visiting midmich.edu/eeo, midmich.edu/titleix, midmich.edu/securityreport.
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