Partnership Request

For questions regarding requests, please contact Geneva A. Stark.

Request Type

First Name

Last Name

Phone ###-###-####

District(s)

School(s)

CEHD Department

Date Needed

Year/Month/Day

Are you requesting Professional Development?

Yes
No

Please describe the area for professional development request

If a specific presenter is desired, please specify (Name, Affiliation)

Anticipated dates for Professional Development

Estimated Funding

If making a request for research, what is the research question?

Please describe the benefits of this research to the district, school, and UofL.

If making a request for data, please specify the data requested/needed.

Specify if "Other"

Funding

Please answer the following

Receiving a confirmation page about your submission acknowledges your submission is complete.