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Name of committee
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Name of current Chair
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Email address of person completing this form
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A copy of the responses will be sent to this email address upon completion of the form.
Date
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MM slash DD slash YYYY
Reconstitution Information
Do you recommend your committee for reconstitution (continuation)?
Yes
No
Next Chair Recommendation: List three unranked names of potential Chairs with a rationale for each person.
Please list each candidate in alphabetical order by last name; include a similar amount of information about each candidate; and include similar kinds of information about each candidate. For example, if you list educational background, current position, and other professional educational activities about one candidate, please include the same information for each candidate.
Name
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Rationale
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Name
(Required)
Rationale
(Required)
Name
(Required)
Rationale
(Required)
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