Retirement/Resignation Notification

Advisor Change – Departing Advisor

"*" indicates required fields

Advisor Name*

First Last

Activities*

HS Speech

ML Speech

Theatre (One-Act)

Debate

Film

Years*

Approximate total number

Please enter a number from 1 to 70.

Reasons for Departure

This data helps us consider ways to address retention and better support advisors.

Accomplishments

Briefly describe accomplishments of which you’re most proud, list organizations and respective leadership positions held.

Future Engagement*

How should we engage/contact this person?

Certificate Acknowledging Service

Email List – General Updates

Consider as an adjudicator

Remove from all contacts

Email*

Please use a non-school email address.

Address*

Address to send certificate of service

Street Address Address Line 2 City State ZIP Code