Attention: Please have the Council/Committee Chair Biographical information and a written statement of the Chair's willingness to serve before you complete this form. This information will be required in order to complete and submit the form.

* Required

Proposed Council/Committee Name *

Parent Committee/Council *

Type of Committee: * Select a committee... Standing Committee Task Committee Subcommittee Council

Committee Purpose (for publication in ASCE Official Register) *

Committee Objectives (Publication and other end products) *

Committee Officers (All must be EWRI Members)

Chair Information:

Chair Name *

Address * ASCE/EWRI ID# *

City * State * Zip * Home Phone *

Preferred E-mail Address * Alternate E-mail Address

Preferred Fax Number * Alternate Fax Number

Educational Background (degrees and dates) *

Past Organizational Participation: *

EWRI/ASCE Service (list committees/councils and positions held): *

Past Service to other Professional & Technical Organizations (list organizations and positions held): *

Vice Chair Information:

Vice Chair Name *

Address * ASCE/EWRI ID# *

City * State * Zip * Home Phone *

Preferred E-mail Address * Alternate E-mail Address

Preferred Fax Number * Alternate Fax Number

Educational Background (degrees and dates) *

Past Organizational Participation: *

EWRI/ASCE Service (list committees/councils and positions held): *

Past Service to other Professional & Technical Organizations (list organizations and positions held): *

Secretary Information:

Secretary Name *

Address * ASCE/EWRI ID# *

City * State * Zip * Home Phone *

Preferred E-mail Address * Alternate E-mail Address

Preferred Fax Number * Alternate Fax Number

Educational Background (degrees and dates) *

Past Organizational Participation: *

EWRI/ASCE Service (list committees/councils and positions held): *

Past Service to other Professional & Technical Organizations (list organizations and positions held): *

Additional Information

List of other committee members, if known (non-officers need not be EWRI members)

1 - First Name MI Last Name Email

2 - First Name MI Last Name Email

3 - First Name MI Last Name Email

4 - First Name MI Last Name Email

5 - First Name MI Last Name Email

Check here to include additional members

Control Group Members

A council/committee may have no more than 10 Control Group Members. Officers should be listed as Core Group Members.

Please justify how this committee fulfills the mission and focus of the EWRI: *

Does this committee functionally overlap with other EWRI committees? * Yes No

If yes, explain *

If yes, give names of people contacted and explain nature of contacts that ensure efforts are not duplicated *

Show milestone dates for completion of planned committee activities. *

Show funding requirement for planned committee activies. (Subcommittees are not funded and may omit this section by writing "N/A" in the box.) *

Person preparing this proposal:

Name: *

Email Address: *

By signing below you agree that the information provided in this form is correct and accurate.
Date *		Signed by: *
	(mm/dd/yyyy)