All student clubs and organizations are required to fill out the following form anytime changes on the Executive Board (E-Board) occur.  This information will be used by the Office of Campus Programming & Leadership Development to create a club contact list.
Club/Organization Name:
Applicable Academic Year:
President’s Name:
E-Mail:
Home #:
Cell Phone #:
Canisius ID #:
Vice President’s Name:
E-Mail:
Home Telephone #:
Cell Phone #:
Canisius ID #:
Treasurer’s Name:
E-Mail:
Home Telephone #:
Cell Phone #:
Canisius ID #:
Secretary’s Name:
E-Mail:
Home Telephone #:
Cell Phone #:
Canisius ID #:
Parliamentarian’s Name:
E-Mail:
Home Telephone #:
Cell Phone #:
Canisius ID #:
Other Position 1:
Name 1:
E-Mail 1:
Home Telephone #1:
Cell Phone #1:
Canisius ID #1:
Other Position 2:
Name 2:
E-Mail 2:
Home Telephone # 2:
Cell Phone #2:
Canisius ID # 2:
Other Position 3:
Name 3:
E-Mail 3:
Summer Telephone # 3:
Canisius ID # 3:

Once submitted, any changes can be e-mailed directly to Elaine Mrugala in Campus Programming & Leadership Development at mrugalae@canisius.edu.  Thank you!