SOURCE Partnering Student Group Form Name of Student

SOURCE Partnering Student Group Form
Name of Student Organization:
________________________________________
Outgoing Leader Name/Email:
________________________________________
Incoming Leader Name/Email:
________________________________________
Community Group(s) that Your
Student Group Works With:
(if applicable)
________________________________________
The following information will be updated and posted online. As information changes, please
email SOURCE at [email protected] so that the information can be changed.
Contact Name:
________________________________________
Contact Email:
________________________________________
Contact Phone:
________________________________________
Website, Facebook,
Yahoo Group, Listserv, etc:
________________________________________
Briefly describe your student organization’s mission/purpose and community involvement
activities:
The following information will help SOURCE provide further resources that your group may
need.
Names/Emails for other Student Leaders in your group that should receive important updates:
Would you like to have a mailbox for your group at SOURCE?
Would you like to utilize storage space for your group at SOURCE?
Yes
Yes
No
No