Faculty Award Application

Instructions: Submit your application by the last Wednesday of January, March, May, July, September, and November. Send to Carise Baldwin (cbaldwin@rx.umaryland.edu) with Faculty Award Application in the subject line.

Title of Faculty Award

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Date Submitted (Either type date below or click arrow to open calendar and select date)

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Primary Contact Information

Full Name and Credentials: Click or tap here to enter text. Title: Click or tap here to enter text. School & Academic Department: Click or tap here to enter text. Email Address: Click or tap here to enter text. Telephone Number: Click or tap here to enter text.

Contributor(s) Contact Information (Full name and credentials, title, school and academic department, email address, and telephone number)

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Description of Proposed Activity

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Background

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Purpose and Objectives

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Potential to Further IPE at UMB

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Outcomes

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Budget (UMB faculty members are eligible to apply for up to $2,000 annually. Other USM faculty require a UMB faculty partner and are eligible for up to a $1,000 award).

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