\documentclass{article}

\title{VVG network: application admin form}
\author{}
\date{}


\begin{document}

\maketitle

\begin{flushleft}

\section{Request Admin details}


{\bf Area Chair}

{\bf Assigned unique identifier}

{\bf Title}

{\bf Contact details}

\section{Review Admin details}

{\bf Reviewer 1}

Id:\\
contact details:\\

date review requested:\\
date of reminder:\\
date review recieved:\\

\vspace*{12pt}

{\bf Reviewer 2}

Id:\\
contact details:\\

date review requested:\\
date of reminder:\\
date review recieved:\\

\vspace*{12pt}

(include more reviewers as necessary)

\section{Meeting and notification}

Meeting date:

Notification date:

Decision made:

\end{flushleft}

\end{document}
