EmailMe Form - Upsilon Sigma - Chapter Application Form

1. UAA INSTITUTIONAL MEMBERSHIP STATUS

Are you a current Urban Affairs Association (UAA) Institutional Member? *

Yes

No

Institutional membership run from January 1 - December 31 of each calendar year.
Membership will be verified.

2. INFORMATION ABOUT ACADEMIC INSTITUTION

Name of Academic Institution *

Enter official institutional name only.
DO NOT use abbreviations.

3. INFORMATION ABOUT ACADEMIC UNIT SEEKING CHARTER

Name of Academic Unit *

Enter official academic unit name only.
DO NOT use abbreviations.

Year academic unit was created *

Web Address of Academic Unit *

Faculty & Courses

Number of Full-time Faculty Members *

Number of Part-time Faculty Members *

Upload a PDF OR Word Document of your UNIT'S FACULTY LISTING *

Uploaded document should include the following information about your faculty:
1) faculty name,
2) title, and
3) research/teaching focus.

Supported format: PDF or Microsoft Word

Upload a PDF OR Word Document of your UNIT'S COURSES LISTING *

Information must include 1) course number, 2) course name, and 3) course description.

Supported format: PDF or Microsoft Word

Academic Unit's Degree Offerings

Type of Degree(s) Offered *

Undergraduate (major and/or minor offered)

Graduate

Both undergraduate and graduate

Degree Programs

Degree Programs--Majors and/or Minors (Enter "N/A" in fields that are not applicable) *

	Official Program Name	Degree Granted (i.e., Bachelor, Master, Doctoral)	Number of Current Students in Program
Degree Program 1
Degree Program 2
Degree Program 3
Degree Program 4
Degree Program 5
Degree Program 6

Academic Unit Administrator

What is the title of the unit administrator? *

Name of unit administrator *

First Last

Email address of unit administrator *

Phone number of unit administrator *

Is the unit above applying for a joint charter with another unit at the institution? *

3b. INFORMATION ABOUT ACADEMIC UNIT SEEKING CHARTER

Name of Second Academic Unit *

Enter official academic unit name only.
DO NOT use abbreviations.

Year second academic unit was created *

Web Address of Second Academic Unit *

Faculty & Courses for Second Unit

Number of Full-time Faculty Members in Second Unit *

Number of Part-time Faculty Members in Second Unit *

Upload a PDF OR Word Document of the second unit's faculty listing *

Uploaded document should include the following information about faculty 1) faculty name, 2) title, and 3) research/teaching focus

Supported format: PDF or Microsoft Word

Upload a PDF OR Word Document of the second unit's courses listing *

Information must include 1) course number, 2) course name, and 3) course description.

Supported format: PDF or Microsoft Word

Second Academic Unit's Degree Offerings

Types of Degree(s) Offered at Second Unit *

Undergraduate (major and/or minor offered)

Graduate

Both undergraduate and graduate

Second Academic Unit's Degree Programs

Second Unit's Degree Programs--Majors and/or Minors (Enter "N/A" in fields that are not applicable) *

	Official Program Name	Degree Granted (i.e., Bachelor, Master, Doctoral)	Number of Current Students in Program
Unit 2, Degree Program 1
Unit 2, Degree Program 2
Unit 2, Degree Program 3
Unit 2, Degree Program 4
Unit 2, Degree Program 5
Unit 2, Degree Program 6

Second Academic Unit's Head Administrator

What is the title of the second unit administrator? *

Name of second unit administrator *

First Last

Email address of second unit administrator *

Phone number of second administrator *

4. FACULTY ADVISOR

ALL Upsilon Sigma email AND postal correspondence will be sent to the Faculty Advisor.

Name of Faculty Advisor *

First Last

Professional title of Faculty Advisor *

Email address of Faculty Advisor *

All Upsilon Sigma email correspondence will be sent to the Faculty Advisor.

Confirm email address of Faculty Advisor

Phone number of Faculty Advisor *

Mailing Address of Faculty Advisor

ALL postal mail correspondence will be sent to the Faculty Advisor.

Faculty Advisor's Name *

First Last

Street Address (Line 1) of Faculty Advisor *

Street Address (Line 2)

City *

State/Province/Region *

Zip Code *

Country *

5. ADVISORY COUNCIL (OPTIONAL)

OPTIONAL: The Chapter Advisory Council shall have at least three faculty members or adminstrative staff from your institution. At least one of whom shall be a member of the faculty.

Advisory Council (Enter "N/A" in fields that are not applicable)

	Name	Professional Title
Advisory Council Member 1
Advisory Council Member 2
Advisory Council Member 3
Advisory Council Member 4
Advisory Council Member 5

6. DOCUMENTATION OF INSTITUTIONAL ACCREDITATION

Name of accrediting agency *

Upload documentation of institutional accreditation. *

Supported Format: PDF

Your institution must be accredited by a regional accrediting agency.

7. APPROVAL OF COLLEGE/UNIVERSITY ADMINISTRATION

Upload Endorsement Letter from:
Unit administrator (e.g., Chair, Director, Coordinator) *

Supported format: PDF
Your application must be supported by the unit-level administrator (e.g., chair, director, coordinator)

If you are submitting an application with a second unit, an additional letter is required from the administrator of that unit.

Upload Endorsement Letter from:
An administrator at a level above the unit (e.g., Dean, Provost, Vice-President, President). *

Supported format: PDF
Your application must be supported an administrator at a higher level of authority (e.g., Dean, Provost, Vice-President, President).

If you are submitting an application with a second unit, an additional letter is required from the administrator of that unit.

8. PROPOSED CHAPTER BYLAWS

Upload a copy of your proposed Chapter Bylaws *

9. INDUCTION ELIGIBILITY CRITERIA

Specify the eligibility criteria that will be used to determine which students are eligible for induction into Upsilon Sigma. *

10. PROCESS FOR IDENTIFYING INDUCTEES

Describe the process that will be used to identify eligible students. State the steps involved, and who will be responsible for carrying out this process. *

Include ALL PARTIES that will be involved in the process.

Comments (optional)

Describe any special circumstances or additional information you wish to share that may be relevant to your chapter application.

Applicant acknowledgements and agreement to adhere to Upsilon Sigma policies

If an applicant is not a current UAA Institutional Member, membership must be established prior to receipt of the charter document.

If a charter is granted, the applicant is required to submit an induction list and pay the appropriate fees prior to inducting any student.

To maintain a charter, the successful applicant is required to: pay annual Institutional Membership dues, pay induction fees for any new student inductees (prior to induction), and submit an annual report.