Club Request Form

Purposed name: 

Club chair:

Chair Phone: 

Chair email:

Club purpose: 

Club activities will consist of:

Club description for LiveDAYBREAK website:

Where will the club meet and how often?

Each purposed new club must have at least 5 residents interested in participating.
Please list the residents, not including the club chair:
1. 
2.
3. 
4. 
5. 

     

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