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Club Convo Proposal Form

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Club Convo Request Form
Please select role: Student Staff
Section One - Leader Information
Full Legal Name:*
CWID:*
Division/Department:*
Phone #:*
E-mail:*
Mailing address:*
Mail code/office location:*
Is this a co-led group? Y/N* Yes No
What is your co-leader's contact info?*
Full Legal Name:*
CWID:*
Phone #:*
E-mail:*
Mail code/office location:*
Have You led a Club Convo previously? Y/N* Yes No
How did you hear about this opportunity (Open Ended)*
Section Two - Christian Mission and Leadership

Convocation plays a vital role in Pepperdine's Christian Mission. While we welcome individuals from all backgrounds to participate and partner with us in programs, it is necessary that the leadership aspects of Club Convos directly aligns with the University's explicit Christian mission. As such, we ask that applicants for leadership are followers of Jesus Christ and a professed Christian.

I am a follower of Jesus Christ and a professed Christian* I Affirm
Please share about what your Christian faith practice currently involves (Open ended)*
Section Three - Group Day/Time
Club Convo Title (must be exactly as it will be referenced through the entirety of the semester for record purposes)*
Proposed day of the week*
Proposed time of the day:*
Location:*
Start Date:*
End Date:*
Section Four - Content & Curriculum
What is the spiritual focus of this Club Convo?*
What do you hope to achieve with this study*
Please give a brief description (no more than a paragraph) of this Club Convo for our website*
Please list any specific restrictions (gender, class, area of study, size, etc)*
Curriculum Layout

As Club Convos directly serve Pepperdine's Christian Mission and fulfil and academic component, part of the approval process consists of reviewing the applicant's content and curriculum. Please provide as much information as possible below or upload a document of your 6-session layout with all the necessary information.

(Unfortunately, Convocation cannot provide budgetary resources for books or other materials. We suggest requesting funding from affiliated groups, departments, or divisions you participate in, or having participants purchase their material.)

Materials used (include all podcasts, books, articles, blogs, videos, Scripture, other resources):

By hitting submit I am verifying that I understand I am required to go to at least five sessions to receive any credit for the program. In addition, I am verifying that my schedule will allow me to attend the choices I have listed above.

The deadline for Club Convo Leader Proposal forms has passed. Please check back in January to propose a Club Convo for Spring 2015.