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Request For Committee Appointment Form

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REQUEST FOR COMMITTEE

APPOINTMENT
Dear President Lewis:

I would like to be appointed to the CTU ___________________________Committee. I


understand that I am required to attend monthly committee meetings during the school
calendar year.
NAME ______________________________________________________
SCHOOL ______________________________________________________
SCHOOL TELEPHONE ( ______ )
_____________________________________________
HOME ADDRESS ______________________________________________________
CITY/ZIP ______________________________________________________
HOME TELEPHONE ( ______ )
_____________________________________________
EMAIL ADDRESS
(HOME) www.
__________________ (WORK) www.
________________
LIST OTHER UNION/COMMITTEES AND ______________________________________________________________________________________________

SCHOOL ACTIVITIES ______________________________________________________________________________________________

__________________________________________________________

UNION INVOLVEMENT
DELEGATE /ALTERNATE DELEGATE
 YES  NO
WHY DO YOU WANT TO JOIN THIS ______________________________________________________________________________________________

COMMITTEE? (USE REVERSE SIDE IF ______________________________________________________________________________________________

NECESSARY. __________________________________________________________

_____________________________________________________________ ___________________________________
APPLICANT’S SIGNATURE DATE

_____________________________________________________________ ___________________________________
CHAIRPERSON’S APPROVAL DATE

_____________________________________________________________ __________________________________
LIAISON’S SIGNATURE DATE

_____________________________________________________________ ___________________________________
PRESIDENT’S APPROVAL DATE
ADDRESS and MAIL COMPLETED FORM TO: OFFICE USE ONLY
STANDING COMMITTEES
c/o Karen GJ Lewis, NBCT, President Date Application Processed
Chicago Teachers Union _____________________20___
222 Merchandise Mart Plaza, Suite 400
Chicago, Illinois 60654-1016 Date of Applicant
Notification:___________________20___

Initials ________________
ALM/STANDING COMMITTEES 10-11

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