AAMC Career Development: OFA Registration Funding Application

Applications will be reviewed by the Office of Faculty Affairs to determine who would most benefit from attending the seminar. All applicants will be contacted in sufficient time to submit their materials to AAMC by their deadline.

In addition to this application, also submit your current CV and Letter of Support from your Chair, Vice Chair, or Division Chief via email to Faculty.Affairs@umassmed.edu.

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1. Applying for registration funding to:

AAMC Early Career Women Faculty Development Seminar

AAMC Minority Faculty Career Development Seminar

AAMC Mid Career Women Faculty Development Seminar

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2. Name (Last, First)

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3. Current Rank

Associate Professor

Assistant Professor

Instructor

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4. Degree

PhD

PhD / MD

Other (please specify)

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5. Primary Department

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6. Specialty

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7. Are you currently working on a grant application?

Yes

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8. Are you currently assembling a promotion packet?

Yes

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9. Preferred Email Address

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10. How do you think this seminar would contribute to your success in academic medicine? (Please limit your response to 250 words).

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11. Please describe in 150 words or less your present institutional responsibilities (include Administration, Clinical Education, Research, and Other (where applicable).

In addition to this application, also submit your current CV and Letter of Support from your Chair, Vice Chair, or Division Chief via email to Faculty.Affairs@umassmed.edu.

100% of survey complete.