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Name of Institute Coordinator(s)*
Coordinator(s) Position/Title*
UNCF Institution*
Home Address*
Street Address Address Line 2 City State ZIP Code
Business Address*
Street Address Address Line 2 City State ZIP Code
Home Phone
Business Phone*
Fax
Email*
Enter Email Confirm Email
Check One*
- Femaie
- Male
Proposed Title of Teaching and Learning Institute*
Have you participated in any other UNCF/Mellon Programs?*
- Yes
- No
If yes, which one(s)?
Attach Proposal*
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Accepted file types: doc, docx, pdf.
2-3 page typed proposal describing the Teaching and Learning Institute, including UNCF institutions that will be invited to participate.
Attach Facilitators*
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Accepted file types: doc, docx, pdf.
List of selected facilitators with accompanying biographical information. It is anticipated that persons hired to assist in the facilitation of the Teaching and Learning Institute will be recognized professionals, scholars and/or practitioners in their respective fields.
Attach Facilitators Descriptions*
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Accepted file types: doc, docx, pdf.
A detailed description of the role(s) of the selected facilitator(s).
Attach Curriculum Vitae of the Institute Coordinator(s)*
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Accepted file types: doc, docx, pdf.
Attach Itemized Budget*
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Accepted file types: doc, docx, xls, pdf.
Itemized budget detailing expenses related to the Institute. Please note that funding to support host institutional staffing and technology purchases must be justified.
Attach Assessment/Evaluation*
Accepted file types: doc, docx, pdf, xls.
A detailed assessment/evaluation plan must be included in the application.
Attach Letter of Endorsement*
Accepted file types: doc, docx, pdf.
Letter of Endorsement from the Chief Academic Officer (Note: Letter must detail how the Institute will enhance the teaching and learning environment of the host institution.)
Name
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