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CICS Student Organization Form

This form is being utilized to register your CICS student organization as active for the 2021-2022 Academic Year.
Please answer the questions below regarding your organization and its leaders for the upcoming Fall and Spring semesters.

Contact and Registration Information

Student Name *

SPIRE ID *

E-Mail Address *

Organization's Name *

How many active members does your organization currently have? *

Mission Statement *

Please describe your organization with a mission statement; a mission statement is a short explanation of the organization's ultimate goals.

President Information *

Please list the first name, last name, phone number, and email address of your organization's president.

Vice President Information *

Please list the first name, last name, phone number, and email address of your organization's vice-president.

Third member Information *

Please list the first name, last name, phone number, and email address of your organization's treasurer, secretary, or any third leadership team member.

Faculty or Staff Advisor Name *

Please list the name of your organization's faculty/staff advisor. All student organizations requesting funding from the college must have a CICS faculty/staff advisor.

Faculty or Staff Advisor E-Mail *

Please list the email address of your organization's faculty/staff advisor. All student organizations requesting funding from the college must have a CICS faculty/staff advisor.

Funding

Funding Amount from CICS *

How much funding, in US dollars, is your organization requesting from CICS this academic year?

Last Year's Funding from CICS *

How much funding did your student organization receive from the CICS in the last academic year?

Additional Funding *

Yes

No

If you are requesting additional funding for the 2021-2022 academic year.

Funding Worksheet URL *

Please create a spreadsheet of your proposed budgetary needs in Google Sheets or Office 365, and place a link to the document in this field.

Additional Funding Reason *

Please list the reason(s) for the funding increase.

Alternate Funding *

Yes

No

In-Process

Is your student organization currently funded by any organizations or groups other than CICS? If you answer, “Yes" or "In-Process" above, someone from CICS will reach out to you to discuss your fundraising plans further.

General Logistics

CS Email address Needed *

Yes

No

Would you like an @cs.umass.edu email address for your student organization?

Events in campus spaces *

Yes, we hope to use the CICS spaces.

Yes,we hope to use spaces like the Campus Center and the ILC.

No

Unsure

Do you intend to have events in campus spaces this year?

Additional Event Info *

If you answered yes to the previous question, please tell us about the kinds of upcoming events your organization is planning. For example, you might say you are planning a series of talks with alumni, a student-run conference, or a hackathon.

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Manning College of Information and Computer Sciences | 140 Governors Dr., Amherst, MA 01003 | (413) 545-2744 | info@cics.umass.edu

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