Minors’ Programs Registration Form

Program Operator Name:*
First Last
Phone:*
Email:*
Sponsoring Department:*
Sponsoring Department's Local Funds Account #
List
Funding Dept ID #: Fund Cat #: Fund #:
List
Function #: Project # (if applicable):
Program Details:
List*
Program Name: Number of Participating Minors:
Program Start Date:*
MM slash DD slash YYYY
Program End Date:*
MM slash DD slash YYYY
List any additional Program Dates
Program Description:*
In the following fields, please submit the names and email addresses of all employee(s) and student(s) involved in the program. This form will only accept 40 participants. If you have additional participants, please email their names and contact info to compliance@unthsc.edu.
List*
Name of Participant: Participants Email: Is Participant a student or faculty/staff:
Which Policies and Procedures will be reviewed with the Minors?

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This page was last modified on May 10, 2023

Name of Participant:	Participants Email:	Is Participant a student or faculty/staff:

Sponsoring Department's Local Funds Account #