Assistant Declaration Form
Please complete this form to officially declare your role, responsibilities, and agreement as an assistant.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Department / Area of Assistance
*
Supervisor's Name
*
First Name
Last Name
Position or Role Title
*
Start Date of Assignment
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Duration of Assignment (if applicable)
Brief Description of Duties and Responsibilities
*
Have you previously served as an assistant?
*
Yes
No
Signature (Please sign to confirm your declaration)
*
Submit Declaration
Submit Declaration
Should be Empty: