Commission for Blacks Membership Form

Name *
Email Address *
Phone Number
UTK Affiliation *
 Undergraduate Student 
 Graduate Student 
 Faculty 
 Staff 
Exempt or Non Exempt
 Exempt 
 Non Exempt 
Department, Unit, or Major
Do you have any skills or expertise that would be of special interest to the Commission for Blacks?
How can the Commission for Blacks assist you with the growth of your department, unit, or organization?
Are you a member of any other organizations or groups?
In our commitment to diversity, we try to make sure the commission represents our diverse population. What diversity would you bring to the commission? (Optional)
What interest you about being a part of the Commission for Blacks?
Committee Preferences - Commissioners are expected to serve on, and actively participate in, at least one standing committee.
 Faculty/Staff/Administrators Interest Committee 
 Student Interest Committee 
 Access and Diversity Staff Retention Fund 
 Community Outreach Committee 
 Awards Committee 
 Public Relations Committee 
 Bylaws Committee 
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