Public Relations Duty Acknowledgement Form
Please complete this form to confirm your assignment and acknowledgment of public relations duties.
Full Name of Staff Member
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Department or Team
*
Job Title or PR Role Assigned
*
Duty Start Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Duty End Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Location of Duty Assignment
*
Supervisor or Manager Name
*
Please describe your main responsibilities for this PR duty assignment
*
Do you have prior experience in similar PR duties?
*
Yes
No
Special Instructions or Notes (if any)
Signature of Staff Member
*
Acknowledge Duty
Acknowledge Duty
Should be Empty: