Instructions: Fill out this form for all student organization programs/events. Student organizations must complete and submit this form to the Office of Student Life and Development prior to your program/event. It is optional but recommended to keep a copy of this form.

Organization:
Name: Name: First Last
Email:
Advisor: Advisor: First Last
Advisor Phone: Advisor Phone: - ### - ### ####
Advisor's Email:
Program Information
Program Title:
Program Date: Program Date: / MM / DD YYYY
Start Time: Start Time: : HH MM AM/PM
End Time: End Time: : HH MM AM/PM
Projected Attendance:
Location:
Type of room needed (classroom, lab, lecture hall, etc.):
Reservations for rooms must be scheduled through the Office of Records and Registration. Please email: WPSharedRooms@MissouriState.edu to reserve the space needed.
Summary of the program
Learning Outcomes (pick three from the list shown below)
Approvals

I verify that all information is factual and ready for approval. Further, I verify that all planned activities are in compliance with the rules and regulations of Missouri State University-West Plains, the State of Missouri, and the City of West Plains to the best of my knowledge.

The Office of Student Life and Development only needs to approve events that are going to be open to the entire campus or fundraisers, and not for internal events.

The Office of University Advancement must approve all fundraisers. If the fundraiser is a Bake Sale, this form is NOT required.

By submitting this form, an email will be sent to the Coordinator of Student Life and Development and Office of University Advancement for approval. You will receive a follow up email regarding the approval of this program.
Will you need audio-visual equipment?

Will you need audio-visual equipment? Yes No
The Student Services Office has a sound system for check-out (if available). Student organizations must reserve and check out the equipment. It is the responsibility of the student organization to take care of the equipment, as well as set-up and tear down the equipment (instructions are provided at point of check out).
Do you want a press release for the event?

Do you want a press release for the event? Yes No
Prior to the event: Contact the public relations specialist in the Office of University Communications at least five to six weeks before the event.
After the event: Contact the public relations specialist in the Office of University Communications. If possible, include an event photo.
Is custodial assistance needed for set-up of tables, chairs, etc?

Is custodial assistance needed for set-up of tables, chairs, etc? Yes No
Submit a work order no more than one week in advance.
Will this be a fundraiser?

Will this be a fundraiser? Yes No
Will there be a prizes?

Will there be a prizes? Yes No
Program Learning Outcomes List

Communication
Write coherently and effectively
Speak coherently and effectively
Influence others through persuasive communication
Prepare and deliverer presentations or trainings

Leadership Development
Explore different leadership theories, philosophies and styles, and articulate leadership philosophy
Understand own leadership style and abilities
Delegate tasks appropriately
Develop others through leadership and as a mentor
Explore personal impact as a role model by fostering leadership in individuals/communities
Exhibit ability to articulate a group mission and desired outcomes
Display adaptability and flexibility as a leader
Articulate, made decisions and modeled behaviors that reflect personal values and ethics.
Use complex information from a variety of sources including personal experience and observation to form a decision or opinion
Reinforce personal knowledge by teaching others
Employee critical thinking skills in a variety of contexts
Demonstrate ability to identify problems and offer solutions

Collaboration and Mediation
Work positively and cooperatively with others
Establish mutually rewarding relationships with others
Seek feedback from others
Identify possible individual and group dynamics
Contribute to achievement of group goals or shared vision
Exhibit effective listening skills and respect for the point of view of others
Employee conflict resolution and mediation strategies

Cultural Competence
Develop and reflect an informed perspective on issues of culture, power and privilege
Understand how one’s identity and culture shape one’s perspective
Seek involvement in diverse interests and with people different from oneself
Recognize and respond to the use of stereotypes and assumptions
Examine the advantages and challenges of diverse society
Reflect on how thoughts, language and actions impact the development of inclusive communities
Interact appropriately with people from diverse backgrounds and cultures

Social Responsibility
Understand and participate in developing sustainable positive change
Appropriately challenge the unfair, unjust or uncivil behavior of other individuals or groups
Increase understanding of social justice issues
Connect knowledge, skills, and accomplishments to service learning and volunteer experiences

Self-Awareness
Chose behaviors and environments that promote health and reduce risk
Exhibit and promote behaviors that advance a healthy community
Demonstrate willingness to explore personal beliefs and values
Develop confidence to act based on personal values
Identify personal, work and lifestyle values and understands how they influence decision making
Develop awareness of personal strengths and weaknesses
Reflect on personal morals and ethics
Develop and articulated spiritual beliefs system
Identify the role of spirituality in personal and group values and behaviors

Marketing and Public Relations
Identify and engage target audience
Create a marketing plan
Develop and enhance a marketing brand
Design materials to promote organization involvement and advertise upcoming events
Strategically distribute promotional materials
Build relationships with media outlets
Utilize marketing strategies to engage new and existing members
Promote positive group representation in the community and on campus

Administrative Management
Oversee budget development and maintenance
Budget and allocate funds appropriately
Maintain records, documents, and organization materials
Track and review proposals and applications
Write and appeal for funding proposals
Solicit donations and sponsors
Connect organization’s mission to programming efforts
Evaluate organization’s effectiveness through internal assessment
Spam Protection. Please answer this simple question:
What is "four hundred" as a number?

Program Information

Reservations for rooms must be scheduled through the Office of Records and Registration. Please email: WPSharedRooms@MissouriState.edu to reserve the space needed.

Prior to the event: Contact the public relations specialist in the Office of University Communications at least five to six weeks before the event.
After the event: Contact the public relations specialist in the Office of University Communications. If possible, include an event photo.

Submit a work order no more than one week in advance.

Program Learning Outcomes List

Program Information

Reservations for rooms must be scheduled through the Office of Records and Registration. Please email: WPSharedRooms@MissouriState.edu to reserve the space needed.

Prior to the event: Contact the public relations specialist in the Office of University Communications at least five to six weeks before the event. After the event: Contact the public relations specialist in the Office of University Communications. If possible, include an event photo.

Submit a work order no more than one week in advance.

Program Learning Outcomes List

Prior to the event: Contact the public relations specialist in the Office of University Communications at least five to six weeks before the event.
After the event: Contact the public relations specialist in the Office of University Communications. If possible, include an event photo.