Faculty & Academic Affairs

2013 New Faculty Orientation Registration

Name

First: *

Last: *

Current Address and Contact Information

Address 1: *

Address 2:

City: *

State / Province:

ZIP / Postal Code: *

Country:

Email Address: *

Phone number: *

Degree Information

Highest degree received: *

Date Received: *

(month and year)

Institution: *

Employment

Last Institution of Employment: *

University of Minnesota

Department: *

Rank:

Or Rank - Other:

Identity

I identify as (check as many as apply):

American Indian/Alaska Native

Asian

Black/African American

Native Hawaiian/Other Pacific Island

Hispanic/Latino

White

Other:

I am interested in receiving mailings and other correspondence for faculty of color:

Yes

No

I identify myself as an international faculty member:

Yes

No

Orientation Dates

I plan to attend (check all that apply): *

Tuesday, August 20, 2013

Wednesday, August 21, 2013

Thursday, August 22, 2013

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