Office of Student Activities & Leadership Student Organization Membership Roster As required for organization registration each semester, please fill out the following form and click submit. If you wish to confirm the receipt of your submission, please email sal@neu.edu, or call 617-373-2642
	Student Organization Name (no acronyms, please)
	Member #1 name (first,last)
	Member #1 cell phone number (xxx-xxx-xxxx)
	Member #1 last four digits of NU ID
	Member #1 NEU email address
	Member #2 name (first, last)
	Member #2 cell phone number (xxx-xxx-xxxx)
	Member #2 last four digits of NU ID
	Member #2 NEU email address
	Member #3 name (first, last)
	Member #3 cell phone number (xxx-xxx-xxxx)
	Member #3 last four digits of NU ID
	Member #3 NEU email address
	Member #4 name (first, last)
	Member #4 cell phone number (xxx-xxx-xxxx)
	Member #4 last four digits of NU ID
	Member #4 NEU email address
	Member #5 name (first, last)
	Member #5 cell phone number (xxx-xxx-xxxx)
	Member #5 last four digits of NUID
	Member #5 NEU email address
	Member #6 name (first, last)
	Member #6 cell phone number (xxx-xxx-xxxx)
	Member #6 last four digits of NU ID
	Member #6 NEU email address
	Member #7 name (first, last)
	Member #7 cell phone number (xxx-xxx-xxxx)
	Member #7 last four digits of NUID
	Member #7 NEU email address
	Member #8 name (first, last)
	Member #8 cell phone number (xxx-xxx-xxxx)
	Member #8 last four digits of NU ID
	Member #8 NEU email address
	Member #9 name (first, last)
	Member #9 cell phone number (xxx-xxx-xxxx)
	Member #9 last four digits of NU ID
	Member #9 NEU email address
	Member #10 name (first, last)
	Member #10 cell phone number (xxx-xxx-xxxx)
	Member #10 last four digits of NU ID
	Member #10 NEU email address
	Member #11 name (first, last)
	Member #11 cell phone number (xxx-xxx-xxxx)
	Member #11 last four digits of NUID
	Member #11 NEU email address
	Member #12 name (first, last)
	Member #12 cell phone number (xxx-xxx-xxxx)
	Member #12 last four digits of NUID
	Member #12 NEU email address