Monthly Newsletter Submission Form Name(Required) First Last Title:(Required) Email(Required) Department:(Required)(please choose one)Office of Student AffairsOffice of the DeanOffice of AdmissionsOffice of Faculty Affairs & Professional DevelopmentOffice of Accreditation, Quality & StrategyUndergraduate Medical EducationGeneral/OtherGeneral/Other (Please Describe) - sub section(Required)(choose one)Professional ServicesResearch & ScholarshipPlease use this example to format your content submission: Name (Last, First), Academic Rank (Assistant, Associate Professor), Department of (i.e., Medical Education), add your recent academic service engagement (name of agency, focus of work, dates) Please use this example to format your content submission: Name (Last, First), Academic Rank (Assistant, Associate Professor), Department of ( i.e., Medical Education) presented or published a virtual poster titled “xxxxx” at the “xxxx” conference and date. Content You can submit up to four entries per request form.Entry One - Subject(Required) Entry One - Content(Required)Entry Two - Subject Entry Two - ContentEntry Three - Subject Entry Three - ContentEntry Four - Subject Entry Four - ContentFileAccepted file types: docx, pdf, jpg, gif, png, Max. file size: 10 MB.CAPTCHA
