Global REACH Faculty Associate Application

Faculty Associate Information

Thank you for your interest in becoming a Faculty Associate of Global REACH. You should expect to hear back from us within 30 days after completion of this application about your status. If you have any questions or need clarification, please email us at globalreach@umich.edu.

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Personal Information:

Full Name:

Preferred email:

Professional titles/degrees:

Home department:

Home division (if applicable):

Additional department/school affiliations (if applicable):

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In 1-2 sentences, please describe your primary focal areas in global health:

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Please list your countries of interest:

	Global REACH Platform Country	Country 1	Country 2	Country 3
Country/countries of interest	Country/countries of interest Global REACH Platform Country menu	Country/countries of interest Country 1 menu	Country/countries of interest Country 2 menu	Country/countries of interest Country 3 menu

Other Countries (if not listed above)

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Please list your 3-5 most recent global health publications (if applicable):

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Please briefly describe any current or recent global health grants, including the funding source, approximate amount, and countries / institutions with which you are collaborating:

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Please briefly describe any unfunded global health initiatives that you are working on that you believe are worth highlighting:

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Twitter handle? (We'll follow you from @UMGlobalreach)

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I have provided a recent CV to Global Reach.

yes

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I have sent a photograph (or link to my departmental homepage profile which includes a photograph) to Global REACH

yes