Affiliate Faculty Request

If you are a current University of Florida faculty member, and would like to be an affiliate faculty member in the Department of Pharmacology & Therapeutics, please complete the steps below.

Full Name:(Required)

Current Title:(Required)

UF ID:(Required)

Email:(Required)

Phone #:(Required)

Primary Departmental Affiliation:(Required)

Campus PO Box #:(Required)

Please describe (<400 words) why you are requesting affiliate status with the Department of Pharmacology & Therapeutics(Required)

Please confirm that you've spoken to Departmental faculty leadership prior to submission:(Required)

Yes, I have.

I am requesting graduate faculty status through Pharmacology & Therapeutics:(Required)

Yes

I am requesting affiliate faculty status with Pharmacology & Therapeutics:(Required)

Yes

Please upload a complete CV:(Required)

Max. file size: 125 MB.

CV must include all of your mentoring and teaching activities.

Signature of Applicant(Required)

By signing, you agree to the expectations of mentors to hold graduate faculty status in the Department of Pharmacology & Therapeutics.