Minors’ Programs Registration Form

Program Operator Name:*
First Last
Phone:*
Email:*
Sponsoring Department:*
Sponsoring Department's Local Funds Account #
Funding Dept ID #:*
Fund Cat #:*
Fund #:*
Function #:*
Program # (if applicable):
Program Details:
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?
CAPTCHA

Sponsoring Department's Local Funds Account #

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