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Committee/Task Force Request
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Committee/Task Force Request
Please enable JavaScript in your browser to complete this form.
Name (Person submitting request)
*
Applicant Email
*
Applicant Telephone Extension
*
Proposed Committee/Task Force Name
*
Proposed Committee/Task Force Purpose
*
Proposed Committee/Task Force Chair
*
Chair Email
*
Chair Telephone Extension
*
If you are requesting a
committee
, the ongoing purpose and charge of the committee will be reviewed annually. If you are requesting a
task force
, you will need to give a beginning and end date for the task force.
I am Requesting
A Committee
A Task Force
Please propose a charge for your committee or task force: what is the group’s purpose?
Please indicate a beginning and end date for the task force
Task Force Begin Date
Task Force End Date
Membership
Indicate proposed committee or task force membership below. Note that these are requests and they are subject to change based on current committee/task force assignments, individual skills, availability, and other factors. If the work of the committee or task force requires more than ten (10) members, please attach an explanation regarding the need for additional members.
Member 1 Name
Member 1 Department/Division
Member 1 Title
Member 1 Term Length
Member 2 Name
Member 2 Department/Division
Member 2 Title
Member 2 Term Length
Member 3 Name
Member 3 Department/Division
Member 3 Title
Member 3 Term Length
Member 4 Name
Member 4 Department/Division
Member 4 Title
Member 4 Term Length
Member 5 Name
Member 5 Department/Division
Member 5 Title
Member 5 Term Length
Member 6 Name
Member 6 Department/Division
Member 6 Title
Member 6 Term Length
Member 7 Name
Member 7 Department/Division
Member 7 Title
Member 7 Term Length
Member 8 Name
Member 8 Department/Division
Member 8 Title
Member 8 Term Length
Member 9 Name
Member 9 Department/Division
Member 9 Title
Member 9 Term Length
Member 10 Name
Member 10 Department/Division
Member 10 Title
Member 10 Term Length
If the work of the committee or task force requires more than ten (10) members, please attach an explanation regarding the need for additional members.
Expected number of meetings per academic year
Submit
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