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All questions marked by an asterisk are required

Event Name:

Professional Development Programming Recommendation

Welcome to the Professional Development Recommendation submission form. This is an opportunity to share your ideas and suggestions for professional development programming. Your input will help us tailor experiences that meet the needs of USC faculty/instructors. Please nominate a colleague or self-nominate, completing this form with as much detail as possible. We are accepting submissions from USC Columbia, Palmetto College, School of Medicine (Columbia and Greenville), and GTAs for themselves or one of their USC colleagues to present.

Submitter Information

*First Name:

*Last Name:

*Email Address:

*Retype Email Address:

*College/School/Department:

*Position:

*Preliminary Title/Topic:

*Presentation Description:

*Is this a recommendation for a colleague or yourself to present?

Myself as Presenter
Colleague as Presenter

Recommended Presenter(s) Information

*Presenter(s) Name:

*Presenter(s) Email Address:

*Presenter(s) College/School/Department:

*Presenter(s) Position:

*Presenter(s) Relevant Experience (experience in the area of the proposed topic):

Recommended Professional Development Programming Information

*Relevant Experience (experience in the area of the proposed topic):

*Learning Objectives:

*Format (e.g., lecture, interactive workshop, panel discussion):

*Length (30 minutes, 50 minutes, 75 minutes, etc.):

*Target Audience (e.g., new faculty, experienced faculty, adjunct faculty, graduate students):

*Resources Required (e.g., technology, handouts, supplies):

*Scholarly references related to your presentation:

Save Information:

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