Spousal Collaborator Declaration Form
Please complete the Spousal Collaborator Declaration Form to confirm your collaborative relationship and project details.
Primary Spouse Full Name
*
First Name
Last Name
Collaborating Spouse Full Name
*
First Name
Last Name
Primary Spouse Email Address
*
example@example.com
Collaborating Spouse Email Address
*
example@example.com
Relationship Confirmation
*
Legally married
Domestic partnership
Civil union
Other
Project or Collaboration Title
*
Brief Description of the Collaboration
*
Start Date of Collaboration
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Expected or Actual End Date of Collaboration
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Acknowledgment of Collaborative Participation
*
I confirm the above information is accurate and both parties are aware of this declaration.
Submit Declaration
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