TSP Application Form

Use this form to apply for the Teaching Scholars Program by the deadline of April 1 of the current academic year. For application instructions, see https://meded.ucsf.edu/faculty-educators/faculty-development-resources/teaching-scholars-program

For questions, contact Victoria Ruddick, ruddickv@ucsf.edu, 415-476-7164.

Personal Information

First Name

Preferred Name (if different)

Last Name

Degrees

Phone

Work Address/Box No.

Gender

Race and/or Ethnicity

UCSF School/Dept

My Teaching Settings

What type of learners do you teach? Select all that apply.

Start date of original UCSF appointment

If you don't know the exact day, choose the first day of the month.

mm/dd/yyyy

Departmental Support

This section is to let us know who will support your application and can approve release time. We will send a simple online attestation form for the person to complete in lieu of a letter. See instructions: http://tiny.ucsf.edu/TSPLoS

Department Chair or Division Chief Email

Alternate Departmental Leader Email

Please provide the email of a departmental leader (if other than your chair) that we should contact.

Attach and Submit

Please assemble Goals Statement and CV into one pdf and upload. Upload limit is 30 MB.

Drop your files here

Goals Statement

I am attaching a Goals Statement document with my application, and I have reviewed the instructions, https://meded.ucsf.edu/faculty-educators/faculty-development/teaching-scholars-program

I am attaching my CV with my application. The CV is in UCSF Format.

Yes

Contact for Departmental Support

I am providing the name of a departmental leader who supports my application, and I have reviewed the instructions, http://tiny.ucsf.edu/TSPLoS

Send me a copy of my responses

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