Committee Representation Update Request Form

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Department Chairs and Deans should utilize this form to submit any changes to committee representation. Changes submitted 72 hours before the next Academic Senate Council meeting will be agendized for ratification. Anything submitted within less than 72 hours will be agendized for the following Senate Council meeting.

Name *

Department/Division *

Title *

Which Committee are you wishing to submit a change request for? *

Please provide the Name of the faculty member or student who will now serve on this committee *

Which department/division/organization will this faculty member be representing? *

Will this faculty member be serving as a primary or alternate representative? (If student, write N/A) *

Who (if anyone) is this faculty member/student replacing? *

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