Request Approval for Faculty Member to Obtain Outside Appointment

1. Faculty member completes the form titled Faculty Request to Obtain an Outside Appointment: https://www.feinberg.northwestern.edu/fao/docs/admin-general/request-for-outside-appt.pdf 2. Department Chair reviews and signs the form if supportive. 3. Department administrator submits the signed form and supporting documentation through this online form for review by the Office of Regulatory Affairs.

Faculty First Name

Faculty Last Name

NU Employee ID of Faculty Member

Feinberg Primary Department

Outside Institution Name(s)

Outside Institution Location(s)

Outside Appointment Start Date

Outside Appointment End Date

If this is an ongoing appointment, leave the end date blank.

Notes

Upload the form titled Faculty Request to Obtain an Outside Appointment, signed by both the faculty member and the Department Chair. Also upload any contractual agreements or appointment letters from the outside institution.

Drop your files here

Submitted By

This online form will generally be submitted by an administrator. Please provide your name and contact info below.

Your Name

Your Email

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