Form 1
Initiating Personnel Committee
(
)
JPC
(
)
SPC
(
)
Special PC
IPC Chair
IPC Secretary
Note: The minimum size of an IPC shall be five voting members.
Note: Although the chair of a departmentalized academic subdivision is a full participant in discussions, that individual
shall not vote.
Note: Your signature below shows you consider the IPC report to be accurate, NOT that you necessarily agree with the
IPC’s vote.
List all eligible IPC members
Signature of those participating*
Department Chair (non-voting)
*Signatures are only needed for those voting.
*Explain why a member did not participate.
*Please note those on leave (in residence or not in residence) who are voting or non-voting members.