Faculty Development | Program Submission Form

Do you have ideas for potential faculty development programming within the Medical School? If you have an idea and would be interested in facilitating a faculty development program, please submit your idea by completing the form below.

First name:

Last name:

Rank:

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Department:

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If other, please note your department here:

Email:

Are you the person who will lead and facilitate this program?

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If no, or if there are additional facilitators, please provide the name(s), degree, rank, department, and contact information for the person(s) who will lead and facilitate this program:

Program topic:

Program title:

Program learning objectives:

Program overview/description:

What competency(ies) does your program fit into (check all that apply)?

Go here to view OFA's faculty development competencies: z.umn.edu/OFAFDCompetencies

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Audience level (check all that apply):

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Time length of program:

Proposed date(s) of program - are you willing to present this program more than once?

Presentation technique (check all that apply):

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Please upload any material or documentation (if applicable) regarding this program:

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