Multicultural Affairs Committee

Member Information

(Please Print)

Date : __________________________
Name : _____________________________________________________________
Position/Title : _______________________________________________________
Division : __________________ Program : ________________________________
Supervisor : ____________________________
Office Mailing Address : ______________________________________________
Office Telephone : ____________________________________________________
Primary Telephone : ___________________________________________________
Special Interests/ Comments : __________________________________________
Please indicate your Committee interest:
Please mark at least ONE
Diversity Conference ______
Diversity Calendar _____
Promotion, Retention, Recruitment and Public Relations _____
Memberships, Food Festivals, Brown Bag Lunches _____
Policy Review _____
Historical Archives _____

 

Supervisor signature: ______________________________________________________

 

Return completed form to: Jennifer Martin, APCP, 1659 E. Elm Street, J.C., Mo 65102

The Multicultural Affairs Committee (MAC) recognizes that the employee is volunteering his/her time to attend meetings, plan events and participate in MAC-sponsored functions. Active membership is beneficial to the productivity and success of MAC.  An active member will be defined as a member who attends any regularly scheduled or special meeting and/or participates in any MAC-sponsored event no less than four times a year.

We look forward to working with you.