Advisory Committee Nomination Form

This form is to be used by staff and SAC members interested in serving on an Advisory Committee.

Advisory Committees are established on an as-needed basis in accordance with the Policy on the Appointment and Reappointment.

Individuals may be nominated by themselves or someone else from their constituency.

Eligibility to serve is dependent on the Advisory Committee in question and the constituency for which the nomination is submitted.

  • Name * Required
  • What is your affiliation? * Required
  • Do you accept the nomination and are you willing to serve on the committee, if selected? Or, if submitting the nomination on behalf of the nominee, have you confirmed with the individual that they accept the nomination and are willing to serve, if selected? * Required
  • Brock University is committed to respecting, fostering, and supporting diversity and inclusion within committees and other bodies. Please indicate any of the following designated group(s) with which you wish to be self-identified. You are not required to self-identify if you do not wish to do so. Please select ‘I choose not to self-identify’ if you do not wish to answer.
    The information collected with respect to self-identification will be stored in a secure and confidential file in the Office of the Provost and will not be shared. The information will be destroyed within one month of the confirmation of the nomination.
  • This field is for validation purposes and should be left unchanged.