Manage your Committee Membership

Name *

Honorific, First Name, Last Name

Institution *

Name of the institution that the member belongs to

Title *

Member's title with the institution

Institution Email *

Use the institution assigned email address

Phone Number *

Work or Cell Number

Comments

Provide any comments and/or further details you would like to share

Replacement Member

Enter the details for the member that will be replaced.

Name *

Honorific, First Name, Last Name for the member being replaced

Institution *

Name of the institution that the member being replaced belongs to

Email *

Institution assigned email address for the member being replaced

Phone Number *

Length Time for Replacement *

Please indicate for how long the replacement is occurring for (e.g., a year sabbatical, permanently, etc).

Comments

Please provide any other comments regarding the replacement