Committee Chair Agreement Form
Please complete this agreement form to confirm your role and responsibilities as Committee Chair.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Committee Name
*
Chair Term Start Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Chair Term End Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Primary Responsibilities as Chair
*
Previous Experience Relevant to This Role (optional)
Digital Signature
*
Submit Agreement
Submit Agreement
Should be Empty: