Fillable Emeritus Nomination Form V4 (California State University Channel Islands)

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Emeritus Nomination Form V4 (California State University Channel Islands)

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Revised 7/19/17
Emeritus/a Nomination Form (per SP 06-16)
Nominee’s Name:
Program:
Nominee’s Home Address:
City, State, Zip:
Nominee’s CI Email Address:
Chair of
Nominating Program:_____________________________________
Date:
Dean of School: _________________________________________
Date:
Provost: ________________________________________________
Date:
PLEASE SUBMIT COMPLETED FORM TO FACULTY AFFAIRS
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Emeritus Nomination Form V4 (California State University Channel Islands)

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Completed 27 July 2020

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