Committee Request Form

Committee on Committee Request Form

On behalf of the Committee on Committees (CoC), please answer the questions below to request a faculty representative. For questions, please email CoC Analyst Sarah Miller (sarah.miller@ucr.edu).

To assist the Committee on Committees in identifying the most suitable representative(s), please answer every question marked as required. Where a required question does not apply, please write “n/a.” The others are optional.

Requestor Information

Requestor's First & Last Name

Requestor’s Title (optional)

Requestor’s Org/Unit (optional)

Requestor's UCR Email Address (one ending in ucr.edu)

Request Details

How many Academic Senate faculty are needed? (1 to 10)

Is the request for CoC to appoint these representatives or submit a slate of names?

Appointments from CoC are vetted; slates of names typically are not vetted depending on the deadline.

Slate of names to be chosen from CoC appointment

Official Committee Charge Please include: 1) overview, scope, function; 2) authority; 3) membership/terms; 4) roles/responsibilities; 5) demographics/duties.

When and how often will the group meet? Please include meeting modality (e.g., monthly meetings on Wednesdays from 1-3 pm in-person).

Approximate length of service/term limit

Due Date for Nominations Please allow at least 30 days.

Potential Nominees & Additional Info

Potential Nominees (Optional) If you have identified any faculty members the CoC should consider, please list them here.

Additional Information (optional) Is there anything else the Committee on Committees should be aware of?