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<table style="max-width:70em !important; background:#F8FCFF; text-align:center" width="100%" cellspacing="0" cellpadding="0" border="0"> | <table style="max-width:70em !important; background:#F8FCFF; text-align:center" width="100%" cellspacing="0" cellpadding="0" border="0"> | ||
<tr> | <tr> | ||
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<table width="100%" cellpadding="0" cellspacing="0"> | <table width="100%" cellpadding="0" cellspacing="0"> | ||
<tr> | <tr> | ||
<td>Revised: [[ | <td>Revised: [[Special:PermanentLink/7712|February 2008]]<br />Reviewed: [[Special:PermanentLink/11099|May 2016]]<br />Revised: March 2018 ([[Special:Diff/11099/{{REVISIONID}}|changes]])</td> | ||
</tr> | </tr> | ||
</table> | </table> | ||
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</tr> | </tr> | ||
<tr><td colspan="3"> </td></tr> | <tr><td colspan="3"> </td></tr> | ||
<!-- | |||
<tr> | |||
<td>_______________________________________________</td> | |||
<td width="75px"> </td> | |||
<td>_______________________________</td> | |||
</tr> | |||
<tr> | |||
<td>Department Chair/Division Assistant Dean Signature</td> | |||
<td width="75px"> </td> | |||
<td>Date</td> | |||
</tr> | |||
--> | |||
<tr><td colspan="3">Submit completed/signed form to conrecords@unmc.edu</td></tr> | <tr><td colspan="3">Submit completed/signed form to conrecords@unmc.edu</td></tr> | ||
<tr><td colspan="3"> </td></tr> | <tr><td colspan="3"> </td></tr> | ||
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<tr><td colspan="3"> </td></tr> | <tr><td colspan="3"> </td></tr> | ||
</table> | </table> | ||