FACULTY DEVELOPMENT EDUCATIONAL INNOVATIONS GRANT APPLICATION

INSTRUCTIONS:

ALL FIELDS WITH AN ASTRICK (*) ARE REQUIRED FIELDS.

THE BUDGET IS A REQUIRED ELEMENT, THOUGH NOT ALL FIELDS ARE REQUIRED.

THE "SUBMIT" BUTTON MUST BE USED TO FINALIZE THE REQUEST IN THE SYSTEM. AFTER USING THE "SUBMIT" BUTTON, YOU WILL NOT BE ABLE TO RETURN FOR EDITS.

FOLLOW THE JUNIOR FACULTY EDUCATION DEVELOPMENT LINK ON THE AMT GRANTS AND AWARDS WEB PAGE TO LOGIN AS A RETURNING USER TO COMPLETE THE APPLICATION OR TO REVIEW YOUR COMPLETED APPLICATION.

"SAVE PROGRESS" BUTTON ALLOWS YOU TO SAVE AND RETURN LATER BEFORE YOU SUBMIT. YOU MUST CREATE A LOG IN AND PASSWORD. SEE INSTRUCTIONS BELOW.

Form Login Account (optional)

New Users / Returning Users CLICK HERE to setup or return to your account for this form. Creating an account enables you to return to this form and your submitted results. An account will also enable you to partially complete this form and return later to finish the form. The account you establish is only for this form.

EDUCATIONAL BIOSKETCH

LAST NAME *

FIRST NAME *

POSITION TITLE *

e-mail *

CHAIRMAN/DIRECTOR *

UPLOAD LETTER OF SUPPORT FROM YOUR CHAIRMAN/DIRECTOR *

EDUCATION/TRAINING: (Begin with baccalaureate or other professional educaiton such as nursing, and include postdoctoral training)

*

0/1000 words

POSITIONS AND HONORS: List in chronological order previous positions, concluding with your present position. List any honors.

*

0/1000 words

EDUCATIONAL ACTIVITIES: Summarize your educational activities both at UTMB and elsewhere including accomplishments and innovations. Indicate what you consider to be the educational accomplishment you are most proud of.

*

0/1000 words

PHILOSOPHY OF TEACHING: Summarize your personal philosophy of education.

*

0/2000 words

SELECTED PRESENTATIONS AND PUBLICATIONS: List in chronological order

*

0/3000 words

FACULTY DEVELOPMENT EDUCATIONAL INNOVATIONS GRANT APPLICATION

TITLE *

ABSTRACT *

0/1000 words

PROJECT DESCRIPTION *

0/2000 words

EVALUATION/MEASURE OF SUCCESS *

0/1000 words

TIMELINE *

0/1000 words

PLAN FOR DISSEMINATION OF INFORMATION GAINED FOR PROPOSED WORK *

0/1000 words

PLAN FOR DISSEMINATION OF INFORMATION GAINED FOR PROPOSED WORK *

0/1000 words

UPLOAD PROPOSAL SUPPORTING DOCUMENT (OPTIONAL)

BUDGET FOR ENTIRE PROPOSED PROJECT PERIOD (Direct costs only)

(JUSTIFICATION IS REQUIRED FOR ALL ITEMS IN THE FIELDS BELOW. THEY WILL NOT BE CONSIDERED WITHOUT JUSTIFICATION. )

JUSTIFICATION - USE BULLET POINTS

0/500 words

EQUIPMENT $

DESCRIBE BELOW

JUSTIFICATION - USE BULLET POINTS. DESCRIBE EQUIPMENT.

0/500 words

UPLOAD QUOTE

SUPPLIES $

DESCRIBE BELOW

JUSTIFICATION - USE BULLET POINTS

0/500 words

TRAVEL $

DESCRIBE BELOW

JUSTIFICATION - USE BULLET POINTS

0/500 words

OTHER EXPENSES 1 $

PURPOSE

JUSTIFICATION - USE BULLET POINTS

0/500 words

OTHER EXPENSES 2 $

PURPOSE

JUSTIFICATION - USE BULLET POINTS

0/500 words

OTHER EXPENSES 3 $

PURPOSE

JUSTIFICATION - USE BULLET POINTS

0/500 words

OTHER EXPENSES 4 $

PURPOSE

JUSTIFICATION - USE BULLET POINTS

0/500 words

TOTAL DIRECT COSTS FOR ENTIRE PROPOSED PROJECT PERIOD $

0.00

WILL YOU SEEK OTHER FINANCIAL SUPPORT? AND FROM WHAT SOURCE? *

Form Login Account (optional)

New Users / Returning Users CLICK HERE to setup or return to your account for this form. Creating an account enables you to return to this form and your submitted results. An account will also enable you to partially complete this form and return later to finish the form. The account you establish is only for this form.