Full Time Faculty Committee Assignment Request Form Full Time Faculty Assignment Committee Assignment Request Form Please submit the Committee Assignment Request form to the Office of Instruction by April 28th. General InformationSelect your email(Required)Abbott AmarAdriano ChristiAltenhofel JenniferBandy KanoeBeasley MichelleBerry WendyBlake PaulBledsoe AdamBogle DarcyCahoon NathanCarlson KamalaChaidez JoellChampion DianeChung-Wee ChristopherClark AmandaCotto ApoloniaDaley PearlDevine BillDuron CandaceDyer GeoffreyEigenauer JohnEveland SharynFlachmann ChristopherGardner GinaGetty ShelleyGolling GregGonzalez LourdesHershkowitz EricJacobi VickiJarrahian AbbasJimenez Murguia SalvadorKerr DanielleKulzer KellyLytle SteveMaiocco VinceMartinez JulianMartinez MarizaMay JamesMayfield MikeMendenhall JanisMendoza TinaMitchell DavidNishiyama WesleyOja MichelleOver JonathanPage JasonPayne RubyPolski RobinRaber TabithaRangel-Escobedo JuanaReynolds David S.Reynolds JoyRichards KristiRodenhauser DeboraRossi MalloriRoth BeckySmith KennethSmith TerriTaylor ChristopherTravis LoriWebster KyleFind your name in this dropdown.AssignmentCommittee Detail Selection. I will serve on two committees. My committee preferences are indicated below. I will serve on one committee and am requesting Alternative Committee Service. [Select the Alternative Assignment box and at least one preferred committee; complete the alternative assignment request] I will serve as a Chair or Co-chair on one committee. [Select the Chaired preferred committee] Select Committee Preferred/Required Select a Committee Actions Edit Delete There are no Entries. Add Entry Maximum number of entries reached. Add as many committees as indicated by your selection above.Alternative Committee Service Describe the nature of the alternative service for which you are requesting approval. Enter the information in the area below and/or attach document(s). Provide enough information so that your request may be evaluated for approval by the supervising Vice-President. If your request for Alternative Committee Service is approved by the supervising Vice-President, a copy of this form will be returned to you. (Note: A minimum of ten (10) hours of Alternative Committee Service is needed to fulfill one committee assignment. Alternative Committee Service must be completed by the end of the current academic year.) Approved Alternative Committee Service include but are not limited to the following: Service on an institution workgroup such as Board of Authority, Health Benefits, Artificial Intelligence, DEIAA, Curriculum Tech Review, multiple campus committees that meet more than 10 hours a year, service on accreditation committees, new program development, a Faculty Peer Mentor, and special projects. Description of Alternative Committee Service: (include the number of hours necessary to complete the alternative service; add attachments as needed) Alternative Committee Service Alternative Service Number of hours(Required)number of hours necessary to complete the alternative serviceDescribe the nature of the alternative service for which you are requesting approval(Required) Attach documents related to your alternative service request. Drop files here or Select files Accepted file types: pdf, doc, docx, xls, xslx, gif, jpg, jpeg, png, txt, ppt, pptx, rtf, Max. file size: 80 MB. SignatureSignatureDate Month Day Year This field is populated dynamically.
