HSC OfDEI Professional Development Support Request

This form is used when an individual wants to request funding from the UNM HSC Office for Diversity, Equity & Inclusion for conference travel or professional development activities (HSC Learners Only).


For best consideration of sponsorship, please apply at least 45 days prior to the event date(s).


A DEI team member will confirm the receipt of your request. Due to the number of requests received by our office, we must limit the amount of support to $250.00 per trainee.


***Please note that funds are only for DEI-focused activities and are limited annually based on budget availability.

REMINDERS

OfDEI MISSION: To advance inclusivity, diversity, & equity throughout the Health Sciences Center and New Mexico via capacity building, sustainable programs, and collaborations. We also strive to promote inclusivity and diversity throughout the UNM Health Sciences Center as well as seeking to engage communities across New Mexico to advance health equity through programs and sustainable, collaborative partnerships.


URGENCY: If your request is URGENT, please be sure to click on the URGENT FLAG in the form below! We will do our best to meet your needs, but be aware our review process does take some time, so please try to plan ahead and send in your request EARLY!

REQUESTING INDIVIDUAL/ORGANIZATION INFORMATION

Please enter your FIRST & LAST NAME

Please be sure you enter a valid email address that you check regularly!

Please enter your phone number in this format XXX-XXX-XXXX

Select or enter value
Caret IconCaret symbol
Select or enter value
Caret IconCaret symbol
Select or enter value
Caret IconCaret symbol
Select
Caret IconCaret symbol

EVENT/PROGRAM/CONFERENCE INFORMATION

What is the name of the program/event/conference for which you are requesting funding?

City & State

Example: April 1-3, 2024

Limit to 100 words or less.

If DEI-focused, please explain.

Are You Presenting at the Conference?*
Do You Hold a Leadership Role in the Organization Holding the Event?*
Have You Participated in Any UNM Health Sciences Office for DEI Pathway Programs*

Example: PATH, Dream Makers, Health Careers Academy, UHSEP, ClinEd, Ambassadors, Scholars, Test Prep, PrEP

FUNDING REQUEST SPECIFICS

Please format your response as follows $00.00 (ex: $250.00). Maximum request amount for HSC Professional Development Funds requests is $250.00.

If You are a Trainee in a Graduate Program, Have You Received Approval From Your Department and/or Advisor to Attend this Event?*
Have You Requested Financial Support from Other UNM Departments/Units to Attend the Event?*
Have You Received a Commitment of Financial Support from Other UNM Departments/Units to Attend this Event?*
Has UNM Health Science Office for DEI Financially Supported You in the Past?*

URGENCY DETERMINATION

If you require an approval status response in fewer than 10 working days, please check the box. If not, please leave the box blank.

What is the latest date by which you need to receive approval status notification from OfDEI?

FILE UPLOADS

You are welcome to attach files related to this request and a variety of file types are acceptable (PDF, Word, Excel, JPG, PNG, etc.). Examples might include flyers, annual reports, etc.

Drag and drop files here or
Powered by Smartsheet Modern Logo On Light
Privacy Notice|Report Abuse
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.