STUDENT REPRESENTATIVE REQUEST FORM
Name *
Your answer
Email *
Your answer
Your Position Title *
Your answer
Name of Committee *
Your answer
Purpose of Committee *
Your answer
Name of Committee Chair *
Your answer
Frequency of Meetings *
(If the meeting schedule is something other than the the listed options, please describe in "other" option
Next Meeting Date *
MM
/
DD
/
YYYY
Meeting Scheduled Time *
Your answer
Day of Week for the meetings *
Meeting Location *
Your answer
Statement of Understanding *
Please note that your request for a student representative cannot be processed unless specific meeting times and dates are provided. Students are assigned based on availability. Please only submit this form once those details have been confirmed.
Additional Information
Your answer
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