Faculty Advisor Confirmation Form

All fields are required unless marked optional.

Faculty Advisor Information

First name

Last name

Email address

University/Institution

Department/Program

Position/Title

Are you currently a CNS member?

Yes No Unsure

Are you confirming as a new or returning Faculty Advisor?

New Faculty Advisor Returning Faculty Advisor

Faculty Advisor Acknowledgements

Faculty Advisor Role Acknowledgement

Faculty Advisors are asked to support their USR by reviewing relevant communications, providing guidance as needed, encouraging student engagement, and helping ensure USR activities are appropriate for their university context.

I acknowledge and agree to support the CNS USR at my institution.

Time Commitment Acknowledgement

The estimated time commitment for Faculty Advisors is approximately 4 hours per semester, including reviewing communications and supporting the USR as needed.

I acknowledge and agree to the estimated time commitment.

Tracking Sheet / Completion Acknowledgement

I understand that USRs will be asked to complete tracking sheets throughout the year to confirm that they have met the program criteria. Faculty Advisors may be asked to support or verify USR activities as needed.

I acknowledge and understand.

Privacy and Consent Acknowledgement I consent to CNS collecting and using the information submitted in this form for USR program administration and communication.

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