New Student Organization Request Form.

Students submitting an application for a new organization must be enrolled at Boston University School of Public Health. Please be prepared to upload the following documents: 1. Organization's Constitution 2. Membership Roster with signatures (scanned and saved as PDF)

Proposed Name of the Organization*
About the Organization
This is where you describe your group's mission, goals and how it will be represented.
MISSION STATEMENT: PLEASE DESCRIBE THE MISSION AND GOALS OF THE PROPOSED STUDENT ORGANIZATION BELOW:*
All officially recognized student organizations of the Boston University School of Public Health must have a mission relevant to the field of public health/ public health education. In applying for recognition to become an official student organization of the Boston University School of Public Health, students must work with the Office of Graduate Student Life to ensure that the mission of the organization is unique, and cannot be served by an already existent BUSPH student organization.
BRIEF DESCRIPTION OF ORGANIZATION'S EVENTS/PROGRAMS OR ACTIVITIES*
Please give the contact information for this organization's representation/leadership:
Each student organization must choose a minimum of two student leaders - a President to serve as the chief organizer and point of contact, and a treasurer, in charge of monitoring group funds.
PRESIDENT'S NAME:
First Last
BU EMAIL
Phone Number
TREASURER'S NAME:
First Last
BU EMAIL
Phone Number
CREATE A LIST OF ADDITIONAL REPRESENTATIVE(S) WITH THEIR TITLE(S) (IF DESIRED) BELOW:
ADVISOR
To encourage positive interaction between students, teaching and administrative staff, every student organization is required to have an advisor. The advisor must be selected from a faculty or administrative staff member at Boston University.
ADVISOR'S NAME:*
First Last
ADVISOR'S EMAIL:
CAMPUS PHONE NUMBER:*
ON OR OFF-CAMPUS ADDRESS:
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
UPLOAD FORMS
This is the final stage of this online application. You will be asked to upload the following documents: 1. Organization's Constitution 2. Membership Roster with signatures
Organization's Constitution (Attach a File)*
Membership Roster with Signatures (Attach a File)*
For the success and longevity of your group, you must have at least 10 members.

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New Student Organization Request Form.

About the Organization

Please give the contact information for this organization's representation/leadership:

ADVISOR

UPLOAD FORMS