Use the form below to complete information about your departmentName of Your Department *Department Leader *Name of your department's leaderEmail *Phone Department Leader Additional department leaderEmail Phone Department Leader Additional department leaderEmail Phone Department ScopeFunction *What does your department do?Purpose *What does the department propose to accomplish?Target *What demographic does your department focus?Schedule The day, time, and place your department has recurring meetingsDay SundayMondayTuesdayWednesdayThursdayFridaySaturdayTime 000102030405060708091011121314151617181920212223HH000510152025303540455055MMLocation Qualifications for Participation All participants must be a member in good standingsMust have been an active Mt. Rose member for at least ___ months? * Any additional qualifications Any additional qualificationsParticpants List all current participants and their officeeg: John Doe; Secretary VerificationPlease enter any two digits with no spaces (Example: 12) *This box is for spam protection - <strong>please leave it blank</strong>: Make sure you contact administration in regards to any additional access that your department may need.