To receive your committee service stipend, fill out the quarterly committee report below. The form opens on the last week of each quarter and is due on the last day of each quarter. You must have JavaScript enabled to use this form. Name Pronouns Pronouns - Select -He/Him/HisShe/Her/HersThey/Them/TheirsZe/Hir/HirsI do not use a pronounI use all gender pronounsOther; please ask Enter other… Perm Number UC Santa Barbara Email New or continuing student? - Select -NewContinuing I am... - Select -DomesticPermanent ResidentInternational If international, what country? Are you a California resident? Yes No Name of the Committee Committee's Chair(s) Total Hours Worked Date(s) Served Were you a voting member on the committee? Yes No What policies were discussed in the meeting? If none, what was addressed instead? Did you manage to contribute, and if so, what did you manage to say? Did the committee take your comments seriously? Do you think this committee is worth graduate student time? Overall Experience with the committee - Select -PositiveMostly PositiveMostly NegativeNegative Submit Leave this field blank