Faculty Resource & Enhanced Engagement Program Form

Faculty Member Submitting Application*
First Last
Email*
Department*
Date of this program*
MM slash DD slash YYYY
Location of this program*
Time of this program*

: Hours

Minutes

AM/PM
Briefly describe your program*
What resources are your requesting (please include any costs)?*
Mercy Core Value*
Target Audience (ex. freshman biology majors)*
Phone
This field is for validation purposes and should be left unchanged.

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