Request Feinberg Dean's Approval for Memorandum of Understanding (MOU)

Complete this form to submit a Memorandum of Understanding (MOU) to the dean's office for signature.

In general, this form will be used to submit MOUs for individuals with joint University/NMG/Veteran’s Affairs Medical Center Appointments, typically with the Jesse Brown VA Healthcare System. To obtain the latest MOU template and for information on how to complete the MOU, please contact the Office for Sponsored Research, or visit their website:

https://sponsoredresearch.northwestern.edu/resources/policies-guidance/va-mou.html

If you need to reach the Faculty Affairs Office, contact fao@northwestern.edu.

Faculty Details

In this section, identify the faculty member referenced in the MOU.

NU Employee ID*

First Name*

Last Name*

Department*

Select or enter value

Please specify other department*

Division (if applicable)

MOU Details

MOU Type*

Identify the organization with whom NU is entering into this MOU.

Select or enter value

Specify Other Organization*

Request Type*

Select or enter value

MOU Effective Date*

MOU End Date

Notes

File Upload*

Please upload the MOU needing signature. This process only results in obtaining signature from the dean's office. You need to coordinate the signatures for any other parties that need to sign the MOU, and signatures from the faculty member and department chair should be obtained before requesting dean's approval.

Drag and drop files here or

Submitter Details

Please enter your contact information so we know whom to return the signed agreement to or follow up with if there are questions.

Submitter Name (FirstName LastName)*

Submitter Email*

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