University of Texas System - Put office name here

Please complete the following form to propose an issue to the UT System Administration Staff Council. Submission of the form online is anonymous unless you choose to complete the contact information below. If you prefer, you may instead choose to complete the form, print out the page, and submit it in hard copy to:

The University of Texas System Administration Staff Council
201 W. 7th Street ASH 418
Austin, TX 78701

Date: 5/22/2013
Contact Information Providing your name and contact information is optional. If submitted, this information will be kept confidential and will only be used by the Staff Council to follow up with if you agree to be contacted.
Name
Phone #
Email
Street Address:
City, State, Zip:
May we contact you to discuss this issue further?
What is the issue you are concerned about? (Required)

What is the desired outcome that would help resolve this issue for you? (Required)

Additional information or comments:

Issue Proposal Form