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Faculty Award Nomination for Scholarship in Community Engagement

Name of faculty member (include credentials):

Title of faculty member:

Faculty email address:

Faculty phone number:

Department, School of primary KU Medical Center faculty appointment:

Please attach an abbreviated CV for the nominee (not to exceed 5 pages), emphasizing engaged scholarship activities. Word document or PDF are acceptable formats.
(10MB max)

How has the nominee's scholarly work in community engagement improved the health of Kansans and/or Midwesterners? How has that work furthered national and international scholarship? Please attach a word document or PDF explanation, not to exceed two pages.
(10MB max)

If not self-nominated, please fill out the following:

Nomintator Information:

Name:

Email address:

Phone number:

Last modified: Dec 19, 2012